Ethical and legal aspects of research involving older people with cognitive impairment: A survey of dementia researchers in Australia

© 2019 Elsevier Ltd People with dementia are under-represented in clinical research, in part due to the ethical and legal complexities of involving people in studies who may lack capacity to consent. Excluding this population from research limits the evidence to inform care. The attitudes and practices of researchers are key to the inclusion of people with dementia in research, however, there are few empirical studies on researchers' perspectives in this area. A cross-sectional study involved researchers in Australia who had experience in the ethical aspects of conducting dementia-related studies with human participants (n = 70). Data were collected via an online survey from November 2017 to January 2018. Most respondents (97%) agreed with the importance of including people at all stages of dementia in research, yet around three-quarters of respondents perceived ethical and legal rules and processes as unduly restrictive or time-consuming. Researchers reported variable practices in assessing prospective participants' capacity to consent to their studies. Various tools are used for this purpose, ranging from tools designed for research (eg, MacArthur Competence Assessment Tool for Clinical Research) to more general cognitive function screens (eg, Mini Mental State Exam). Few respondents (14%) routinely exclude people from studies who are unable to give their own consent, but instead seek permission from proxy decision-makers, such as legally appointed guardians or family carers. Respondents reported positive and negative outcomes of ethics review processes. Positive outcomes included strengthening the protections for participants with cognitive impairment while negative outcomes included delays and inconsistent decisions from different ethics committees. The findings suggest a need for improved strategies in the research context to assess and enhance the decision-making capacity of people with dementia to support appropriate opportunities for inclusion. Education for ethics committees, proxy decision-makers and other gatekeepers is also needed to reduce barriers to participation in research

Growing dairy heifers in southwest Iowa

Southwest Iowa farmers were looking for a farming enterprise to add value to their forage and grain production and use their labor. The original plan was to grow dairy heifers on pasture in the summer, sell them in the fall, and keep track of the economics of a dairy heifer system

The Influence of Habitat and Fishing on Reef Fish Assemblages in Cuba

The abundance of selected fish species was estimated using the stationary visual census technique in the northwestern region of the Cuban shelf. A total of 26,809 individuals of 32 species were counted in 1,172 stationary point censuses made at 10 reef sites along the coast. We found that the abundance patterns were most probably the consequence of the presence/absence of mangroves and seagrass beds in adjacent lagoon areas. A second factor influencing the spatial variation appeared to be overfishing on an east-west gradient, with lower abundances of commercially targeted species near Havana City in the east

Giant Negative Thermal Expansion Induced by the Synergistic Effects of Ferroelectrostriction and Spin-Crossover in PbTiO3-Based Perovskites

The discovery of unusual negative thermal expansion (NTE) provides the opportunity to control the common but much desired property of thermal expansion, which is valuable not only in scientific interests but also in practical applications. However, most of the available NTE materials are limited to a narrow temperature range, and the NTE effect is generally weakened by means of various modifications. Here, we report an enhanced NTE effect that occurs over a wide temperature range (\alpha V = -5.24 * 10-5 {\deg}C^-1, 25-575 {\deg} C), and this NTE effect is accompanied by an abnormal enhanced tetragonality, a large spontaneous polarization, and a G-type antiferromagnetic ordering in the present perovskite-type ferroelectric of (1-x)PbTiO3-xBiCoO3. Specifically, for the composition of 0.5PbTiO3-0.5BiCoO3, an extensive volumetric contraction of ~4.8 % has been observed near the Curie temperature of 700 {\deg}C, which represents the highest level in PbTiO3-based ferroelectrics. According to our experimental and theoretical results, the giant NTE originates from a synergistic effect of the ferroelectrostriction and spin-crossover of cobalt on the crystal lattice. The actual NTE mechanism is contrasted with previous functional NTE materials, in which the NTE is simply coupled with one ordering such as electronic, magnetic, or ferroelectric ordering. The present study sheds light on the understanding of NTE mechanisms and it attests that NTE could be simultaneouslycoupled with different orderings, which will pave a new way toward the design of large NTE materials.Comment: 30 page

Prevalence of nursing diagnoses as a measure of nursing complexity in a hospital setting

Aims: To describe the prevalence of nursing diagnoses on admission among inpatient units and medical diagnoses and to analyse the relationship of nursing diagnoses to patient characteristics and hospital outcomes. Background: Nursing diagnoses classify patients according to nursing dependency and can be a measure of nursing complexity. Knowledge regarding the prevalence of nursing diagnoses on admission and their relationship with hospital outcomes is lacking. Design: Prospective observational study. Methods: Data were collected for 6 months in 2014 in four inpatient units of an Italian hospital using a nursing information system and the hospital discharge register. Nursing diagnoses with prevalence higher or equal to 20% were considered as \u2018high frequency.\u2019 Nursing diagnoses with statistically significant relationships with either higher mortality or length of stay were considered as \u2018high risk.\u2019 The high-frequency/high-risk category of nursing diagnoses was identified. Results: The sample included 2283 patients. A mean of 4\ub75 nursing diagnoses per patient was identified; this number showed a statistically significant difference among inpatient units and medical diagnoses. Six nursing diagnoses were classified as high frequency/high risk. Nursing diagnoses were not correlated with patient gender and age. A statistically significant perfect linear association (Spearman's correlation coefficient) was observed between the number of nursing diagnoses and both the length of stay and the mortality rate. Conclusion: Nursing complexity, as described by nursing diagnoses, was shown to be associated with length of stay and mortality. These results should be confirmed after considering other variables through multivariate analyses. The concept of high-frequency/high-risk nursing diagnoses should be expanded in further studies

The role of parental alcohol use, parental discipline and antisocial behaviour on adolescent drinking trajectories

Backgrounds: : Parental drinking, harsh parental discipline and adolescent antisocial behaviour have been independently implicated in adolescent alcohol use. Robust prospective studies are required to examine developmental relationships between these factors and their effect on trajectories of alcohol use across adolescence

A sensitivity analysis of the New Zealand standard model of foot and mouth disease

Summary Disease simulation models can be a valuable tool for planning a response to exotic disease incursions, as they provide a fast, low-cost mechanism for identifying the likely outcomes of a range of outbreak scenarios and disease control strategies. To use these tools effectively and with confidence, decisionmakers must understand the simplifications and framing assumptions that underlie a model's structure. Sensitivity analysis, the analytical process of identifying which input variables are the key drivers of the model's output, is a crucial process in developing this understanding. This paper describes the application of a sampling-based sensitivity analysis to the New Zealand standard model (NZSM). This model is a parameter set developed for the InterSpread Plus model platform to allow the exploration of different outbreak scenarios for an epidemic of foot and mouth disease in New Zealand. Based on 200 iterations of the NZSM, run for a simulation period of 60 days, settings related to farm-to-saleyard movements and the detection of disease during the active surveillance phase of the epidemic had the greatest influence on the predicted number of infected premises. A small number of counter-intuitive findings indicated areas of model design, implementation and/or parameterisation that should be investigated further. A potentially useful result from this work would be information to aid the grouping or elimination of non-influential model settings. This would go some way towards reducing the overall complexity of the NZSM, while still allowing it to remain fit for purpose