Linear Classification of Neural Manifolds with Correlated Variability

Understanding how the statistical and geometric properties of neural activations relate to network performance is a key problem in theoretical neuroscience and deep learning. In this letter, we calculate how correlations between object representations affect the capacity, a measure of linear separability. We show that for spherical object manifolds, introducing correlations between centroids effectively pushes the spheres closer together, while introducing correlations between the spheres' axes effectively shrinks their radii, revealing a duality between neural correlations and geometry. We then show that our results can be used to accurately estimate the capacity with real neural data.Comment: 6 pages and 5 figures in main text. 11 pages and 1 figure in supplementary materia

Homelessness among older people: Assessing strategies and frameworks across Canada

Homelessness among older people is expected to rise as a result of unmet need and demographic change. Yet, strategies and responses to homelessness across Canada tend to focus on younger groups, overlooking the circumstances and needs of older people (i.e., age 50+). This article reports the results of a content analysis of government planning documents on homelessness conducted in 2014. A total of 42 local, provincial, and federal strategies were reviewed to assess the extent to which they recognized and targeted the needs of older people. Our review resulted in three categories of documents: 1) documents with no discussion of homelessness among older people (n=16; 38%); 2) documents with a minimal discussion of homelessness among older people (n=22; 55%); and 3) documents with a significant discussion of homelessness among older people (n=4; 7%). Results indicate that while many strategies are beginning to consider older people as a subgroup with unique needs, little action has been taken to develop comprehensive services and supports for this group. We conclude with a call to integrate the needs of diverse groups of older people into strategies to end homelessness and to develop programs and responses that are suitable for older people. L’itinérance parmi les personnes âgées: Évaluations des stratégies et des structures à travers le Canada RésuméIl est prévu que l’itinérance chez les personnes âgées augmentera au cours des prochaines années, en raison des changements démographiques et des besoins non comblés que l’on observe actuellement.  Malgré cela, les stratégies et les réponses à l’itinérance au Canada tendent à être centrées sur les populations plus jeunes, ignorant les besoins et réalités des personnes âgées. Cet article présente les résultats d’une analyse de contenu des stratégies canadiennes sur l’itinérance effectuée en 2014. 42 stratégies ont été recensées afin d’évaluer dans quelle mesure elles reconnaissaient et ciblaient les besoins des personnes âgées. Notre analyse regroupe en trois catégories les documents recensés : 1) les documents qui n’abordent pas l’itinérance chez les personnes âgées (n=16; 38 pour cent); 2) les documents  abordent très brièvement l’itinérance des personnes âgées (n=22; 55 pour cent); 3) les documents abordant de façon substantielle l’itinérance des personnes âgées (n=4; 7 pour cent). Les résultats indiquent que bien que plusieurs stratégies commencent à prendre en considération le fait que les personnes âgées constituent un sous-groupe qui présente des besoins particuliers, peu d’actions ont été entreprises afin de  développer des services et un soutien adaptés à leur réalité. Nous concluons en rappelant l’importance d’intégrer les besoins de différents groupes de personnes âgées aux stratégies qui visent à mettre fin à  l’itinérance et de développer des programmes et réponses qui sont adaptées à une population âgée. Mots Clefs : politique; pratique; vieillissement; exclusion sociale; pauvreté; logemen

Improving the Management of Late-Life Depression in Primary Care: Barriers and Facilitators

The objectives of this study were to elicit Canadian health professionals' views on the barriers to identifying and treating late-life depression in primary care settings and on the solutions felt to be most important and feasible to implement. A consensus development process was used to generate, rank, and discuss solutions. Twenty-three health professionals participated in the consensus process. Results were analysed using quantitative and qualitative methods. Participants generated 12 solutions. One solution, developing mechanisms to increase family physicians' awareness of resources, was highly ranked for importance and feasibility by most participants. Another solution, providing family physicians with direct mental health support, was highly ranked as important but not as feasible by most participants. Deliberations emphasized the importance of case specific, as needed support based on the principles of shared care. The results suggest that practitioners highly value collaborative care but question the feasibility of implementing these principles in current Canadian primary care contexts

Patterns of Shelter Use Among Men New to Homelessness in Later Life: Duration of Stay and Psychosocial Factors Related to Departure

People who become homeless for the first time in late life are a growing but understudied population. This study draws on administrative data from one shelter (N = 1,214 first-time homeless) to assess the extent to which age is related to shelter stay and, to examine psychosocial factors that may be associated with shelter departure. Our bivariate and survival analysis results suggest that older homeless men stay in the shelter 2 weeks longer than younger clients. Older men with pending legal issues and mobility concerns were more likely to leave the shelter than those without such concerns. Findings highlight the impact of age and other psychosocial variables on shelter stay, and provide direction from which to address homelessness among men who are new to homelessness in later life

Meaningful connections in dementia end of life care in long term care homes

Background: Most persons with dementia die in long term care (LTC) homes, where palliative approaches are appropriate. However, palliative approaches have not been widely implemented and there is limited understanding of staff and family experiences of dying and bereavement in this context. Method: This descriptive qualitative study explored family and staff experiences of end of life and end of life care for persons with dementia in LTC homes. Eighteen focus groups were conducted with 77 staff members and 19 relatives of persons with dementia at four LTC homes in four Canadian provinces. Results: Three themes emerged: knowing the resident, the understanding that they are all human beings, and the long slow decline and death of residents with dementia. Discussion: Intimate knowledge of the person with dementia, obtained through longstanding relationships, was foundational for person-centred end of life care. Health care aides need to be included in end of life care planning to take advantage of their knowledge of residents with dementia. There were unmet bereavement support needs among staff, particularly health care aides. Persons with dementia were affected by death around them and existing rituals for marking deaths in LTC homes may not fit their needs. Staff were uncomfortable answering relatives’ questions about end of life. Conclusions: Longstanding intimate relationships enhanced end of life care but left health care aides with unmet bereavement support needs. Staff in LTC homes should be supported to answer questions about the trajectory of decline of dementia and death. Further research about residents’ experiences of deaths of other residents is needed.Brock University Library Open Access Publishing Fun

Aging in the Right Place

Background: This project builds upon a pilot study that documented innovative shelter/housing solutions that have not undergone rigorous evaluation but hold the promise of supporting “aging in the right place” for older persons (50+) with experiences of homelessness (OPEH) in Montreal, Calgary, and Vancouver. “Aging in the right place” means older adults remain in their homes and communities supported by housing, health, social services responsive to their unique lifestyles and needs. While our pilot study identified innovative shelter/housing solutions that support OPEH to establish and maintain a home and work towards aging in the right place, there remains a knowledge gap regarding what works, why it works, and for whom it works. Methods/Design: Through a community-based participatory research approach, we will conduct evaluations of 11 different promising shelter/housing practices to determine the types of practices that appear most useful in supporting aging in the right place, and the groups of OPEH for whom the promising practices work based on intersections of risk (e.g., age, gender, sexual orientation, race/ethnicity, disability, Indigenous status, and immigrant status). Our overall goal is to improve the shelter/housing options to meet the unique and complex health and social needs of OPEH across Canada. Discussion: Program evaluations will offer practice-based evidence of ways in which promising practices of shelter/housing might serve as best practices for supporting OPEH to establish and maintain a home and work towards aging in the right place. Project findings will inform housing, homelessness, health, and social service providers’ design and delivery of programs for OPEH to improve the sustainability of community housing, build provider capacity, and ensure supports that promote aging in the right place are sustained

Aging in the Right Place

Background: This project builds upon a pilot study that documented innovative shelter/housing solutions that have not undergone rigorous evaluation but hold the promise of supporting “aging in the right place” for older persons (50+) with experiences of homelessness (OPEH) in Montreal, Calgary, and Vancouver. “Aging in the right place” means older adults remain in their homes and communities supported by housing, health, social services responsive to their unique lifestyles and needs. While our pilot study identified innovative shelter/housing solutions that support OPEH to establish and maintain a home and work towards aging in the right place, there remains a knowledge gap regarding what works, why it works, and for whom it works. Methods/Design: Through a community-based participatory research approach, we will conduct evaluations of 11 different promising shelter/housing practices to determine the types of practices that appear most useful in supporting aging in the right place, and the groups of OPEH for whom the promising practices work based on intersections of risk (e.g., age, gender, sexual orientation, race/ethnicity, disability, Indigenous status, and immigrant status). Our overall goal is to improve the shelter/housing options to meet the unique and complex health and social needs of OPEH across Canada. Discussion: Program evaluations will offer practice-based evidence of ways in which promising practices of shelter/housing might serve as best practices for supporting OPEH to establish and maintain a home and work towards aging in the right place. Project findings will inform housing, homelessness, health, and social service providers’ design and delivery of programs for OPEH to improve the sustainability of community housing, build provider capacity, and ensure supports that promote aging in the right place are sustained

A pilot evaluation of the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) program

Background: Despite increased annual mortality in long-term care (LTC) homes, research has shown that care of dying residents and their families is currently suboptimal in these settings. The purpose of this study was to evaluate resident and family outcomes associated with the Strengthening a Palliative Approach in LTC (SPA-LTC) program, developed to help encourage meaningful end of life discussions and planning. Methods: The study employs a mixed method design in four LTC homes across Southern Ontario. Data were collected from residents and families of the LTC homes through chart reviews, interviews, and focus groups. Interviews with family who attended a Palliative Care Conference included both closed-ended and open-ended questions. Results: In total, 39 residents/families agreed to participate in the study. Positive intervention outcomes included a reduction in the proportion of emergency department use at end of life and hospital deaths for those participating in SPA-LTC, improved support for families, and increased family involvement in the care of residents. For families who attended a Palliative Care Conference, both quantitative and qualitative findings revealed that families benefited from attending them. Residents stated that they appreciated learning about a palliative approach to care and being informed about their current status. Conclusions: The benefits of SPA-LTC for residents and families justify its continued use within LTC. Study results also suggest that certain enhancements of the program could further promote future integration of best practices within a palliative approach to care within the LTC context. However, the generalizability of these results across LTC homes in different regions and countries is limited given the small sample size

The impact of the mySupport advance care planning intervention on family caregivers’ perceptions of decision-making and care for nursing home residents with dementia : pretest-posttest study in six countries

Background the mySupport advance care planning intervention was originally developed and evaluated in Northern Ireland (UK). Family caregivers of nursing home residents with dementia received an educational booklet and a family care conference with a trained facilitator to discuss their relative’s future care. Objectives to investigate whether upscaling the intervention adapted to local context and complemented by a question prompt list impacts family caregivers’ uncertainty in decision-making and their satisfaction with care across six countries. Second, to investigate whether mySupport affects residents’ hospitalisations and documented advance decisions. Design a pretest–posttest design. Setting in Canada, the Czech Republic, Ireland, Italy, the Netherlands and the UK, two nursing homes participated. Participants in total, 88 family caregivers completed baseline, intervention and follow-up assessments. Methods family caregivers’ scores on the Decisional Conflict Scale and Family Perceptions of Care Scale before and after the intervention were compared with linear mixed models. The number of documented advance decisions and residents’ hospitalisations was obtained via chart review or reported by nursing home staff and compared between baseline and follow-up with McNemar tests. Results family caregivers reported less decision-making uncertainty (−9.6, 95% confidence interval: −13.3, −6.0, P  Conclusions the mySupport intervention may be impactful in countries beyond the original setting