Quality of life and building design in residential and nursing homes for older people

Older people living in residential and nursing care homes spend a large proportion of their time within the boundaries of the home, and may depend on the environment to compensate for their physical or cognitive frailties. Regulations and guidelines on the design of care buildings have accumulated over time with little knowledge of their impact on the quality of life of building users. The Design in Caring Environments Study (DICE) collected cross-sectional data on building design and quality of life in 38 care homes in and near Sheffield, Yorkshire. Quality of life was assessed using methods which included all residents regardless of their frailty, and staff morale was also assessed. The physical environment was measured on 11 user-related domains using a new tool, the Sheffield Care Environment Assessment Matrix (SCEAM). Significant positive associations were found between several aspects of the built environment and the residents' quality of life. There was evidence that a focus on safety and health requirements could be creating risk-averse environments which act against quality of life, particularly for the least frail residents. Staff morale was associated with attributes of a non-institutional environment for residents rather than with the facilities provided for the staff. The new tool for assessing building design has potential applications in further research and for care providers

'Does the design of settings where acute care is delivered meet the needs of older people? Perspectives of patients, family carers, and staff

Background: Older people with an acute illness, many of whom are also frail, form a significant proportion of the acute hospital inpatient population. Attention is focusing on ways of improving the physical environment to optimize health outcomes and staff efficiency. Purpose: This paper explores the effects of the physical environment in three acute care settings: Acute Hospital Site, In-patient Rehabilitation Hospital, and Intermediate Care Provision (a nursing home with some beds dedicated to intermediate care) chosen to represent different steps on the acute care pathway for older people and gain the perspectives of patients, family carers and staff. Methods: Semi structured interviews were undertaken with 40 patient/carer dyads (where available) and three staff focus groups were conducted in each care setting with a range of staff. Results: Multiple aspects of the physical environment were reported as important by patients, family carers, and staff. For example, visitors stressed the importance of access and parking; patients valued environments where privacy and dignity were protected; storage space was poor across all sites; security was important to patients but visitors want easy access to wards. Conclusions: The physical environment is a significant component of acute care for older people, many of whom are also frail, but often comes second to organization of care, or relationships between actors in an episode of care

Model Cards for Model Reporting

Trained machine learning models are increasingly used to perform high-impact tasks in areas such as law enforcement, medicine, education, and employment. In order to clarify the intended use cases of machine learning models and minimize their usage in contexts for which they are not well suited, we recommend that released models be accompanied by documentation detailing their performance characteristics. In this paper, we propose a framework that we call model cards, to encourage such transparent model reporting. Model cards are short documents accompanying trained machine learning models that provide benchmarked evaluation in a variety of conditions, such as across different cultural, demographic, or phenotypic groups (e.g., race, geographic location, sex, Fitzpatrick skin type) and intersectional groups (e.g., age and race, or sex and Fitzpatrick skin type) that are relevant to the intended application domains. Model cards also disclose the context in which models are intended to be used, details of the performance evaluation procedures, and other relevant information. While we focus primarily on human-centered machine learning models in the application fields of computer vision and natural language processing, this framework can be used to document any trained machine learning model. To solidify the concept, we provide cards for two supervised models: One trained to detect smiling faces in images, and one trained to detect toxic comments in text. We propose model cards as a step towards the responsible democratization of machine learning and related AI technology, increasing transparency into how well AI technology works. We hope this work encourages those releasing trained machine learning models to accompany model releases with similar detailed evaluation numbers and other relevant documentation

Chaotic behaviors of stable second-order digital filters with two’s complement arithmetic

In this paper, the behaviors of stable second-order digital filters with two’s complement arithmetic are investigated. It is found that even though the poles are inside the unit circle and the trajectory converges to a fixed point on the phase plane, that fixed point is not necessarily the origin. That fixed point is found and the set of initial conditions corresponding to such trajectories is determined. This set of initial conditions is a set of polygons inside the unit square, whereas it is an ellipse for the marginally stable case. Also, it is found that the occurrence of limit cycles and chaotic fractal pattern on the phase plane can be characterized by the periodic and aperiodic behaviors of the symbolic sequences, respectively. The fractal pattern is polygonal, whereas it is elliptical for the marginally stable case

A 2-step synthesis of Combretastatin A-4 and derivatives as potent tubulin assembly inhibitors

A series of combretastatin derivatives were designed and synthesised by a two-step stereoselective synthesis by use of Wittig olefination followed by Suzuki cross-coupling. Interestingly, all new compounds (2a-2i) showed potent cell-based antiproliferative activities in nanomolar concentrations. Among the compounds, 2a, 2b and 2e were the most active across three cancer cell lines. In addition, these compounds inhibited the polymerisation of tubulin in vitro more efficiently than CA-4. They caused cell cycle arrest in G2/M phase further confirming their ability to inhibit tubulin polymerisation

Photometric and spectroscopic observations of three rapidly rotating late-type stars: EY Dra, V374 Peg and GSC 02038-00293

Here, BV(RI)c broad band photometry and intermediate resolution spectroscopy in Halpha region are presented for two rapidly rotating late-type stars: EY Dra and V374 Peg. For a third rapid rotator, GSC 02038-00293, intermediate resolution Halpha spectroscopy and low resolution spectroscopy are used for spectral classification and stellar parameter investigation of this poorly known object. The low resolution spectrum of GSC 02038-00293 clearly indicates that it is a K-type star. Its intermediate resolution spectrum can be best fitted with a model with Teff=4750K and vsini=90km/s, indicating a very rapidly rotating mid-K star. The Halpha line strength is variable, indicating changing chromospheric emission on GSC 02038-00293. In the case of EY Dra and V374 Peg, the stellar activity in the photosphere is investigated from the photometric observations, and in the chromosphere from the Halpha line. The enhanced chromospheric emission in EY Dra correlates well with the location of the photospheric active regions, indicating that these features are spatially collocated. Hints of this behaviour are also seen in V374 Peg, but it cannot be confirmed from the current data. The photospheric activity patterns in EY Dra are stable during one observing run lasting several nights, whereas in V374 Peg large night-to-night variations are seen. Two large flares, one in the Halpha observations and one from the broadband photometry, and twelve smaller ones were detected in V374 Peg during the observations spanning nine nights. The energy of the photometrically detected largest flare is estimated to be 4.25x10^31 - 4.3x10^32 ergs, depending on the waveband. Comparing the activity patterns in these two stars, which are just below and above the mass limit of full convection, is crucial for understanding dynamo operation in stars with different internal structures.Comment: Accepted for publication in Astronomische Nachrichten (Astronomical Notes

Spectral analysis of 3D MHD models of coronal structures

We study extreme-ultraviolet emission line spectra derived from three-dimensional magnetohydrodynamic models of structures in the corona. In order to investigate the effects of increased magnetic activity at photospheric levels in a numerical experiment, a much higher magnetic flux density is applied at photospheric levels as compared to the Sun. Thus, we can expect our results to highlight the differences between the Sun and more active, but still solar-like stars. We discuss signatures seen in extreme-ultraviolet emission lines synthesized from these models and compare them to signatures found in the spatial distribution and temporal evolution of Doppler shifts in lines formed in the transition region and corona. This is of major interest to test the quality of the underlying magnetohydrodynamic model to heat the corona, i.e. currents in the corona driven by photospheric motions (flux braiding).Comment: 10 pages, 3 figure

Identity work and the `unemployed' worker: age, disability and the lived experience of the older unemployed

This article seeks to explore how older individuals negotiate and manage their self-identity in relation to work while situated without paid employment. After reviewing the current positions of the older unemployed in the UK, noting the substantial overlap between age and disability, we turn our attention to conceptualizing the lived experiences of individuals through exploring `identity work' as a means of understanding a non-working work identity. Based upon focus group interviews, our empirical analysis focuses on key dimensions of participants' identity practice and how they sought to manage the following social processes: imposed identities; crafting working identities; and contesting unfavourable working identities.The conclusion contextualizes the findings against a backdrop of increasing individualistic discourses underpinning approaches to employability, closes with the policy implications arising from this study, and makes suggestions for future research agendas. </jats:p