Living positively with dementia: a systematic review and synthesis of the qualitative literature

Objective: Little is known about how and to what extent people with dementia live positively with their condition. This study aimed to review and carry out a synthesis of qualitative studies where accounts of the subjective experiences of people with dementia contained evidence of positive states, experiences or attributes. Methods: A meta-synthesis was undertaken to generate an integrated and interpretive account of the ability of people with dementia to have positive experiences. A methodological quality assessment was undertaken to maximize the reliability and validity of this synthesis and to contextualize the findings with regard to methodological constraints and epistemological concepts. Findings: Twenty-seven papers were included. Three super-ordinate themes relating to positive experiences and attributes were identified, each with varying and complementing sub-themes. The first super-ordinate theme related to the experience of engaging with life in ageing rather than explicitly to living with dementia. The second theme related to engaging with dementia itself and comprised the strengths that people can utilize in facing and fighting the condition. The third theme captured how people with dementia might transcend the condition and seek ways to maintain identity and even achieve personal growth. Conclusions: This review provides a first step towards understanding what conceptual domains might be important in defining positive outcomes for people who live with dementia. Highlighting the potential for people to have positive experiences in spite of or even because of their dementia has important implications for de-stigmatizing dementia and will enhance person-centred approaches to care

Habitat Quality Modeling for Bird Species at Furman University

In rapidly urbanizing areas, such as Greenville County in Upstate South Carolina, it is important to study habitat use and quality across land cover types in order to maximize conservation. Habitat fragmentation is a threat to many species of birds in areas with increasing development, especially those species that utilize larger forest patches for nesting and foraging. While land cover type and patch size are extremely important factors in determining habitat quality for birds, recent research has shown that the matrix of surrounding landscape proves to be very important as well. The landscape matrix, sometimes called landscape mosaic, considers the land cover characteristics of neighboring areas and interactions between land cover types. Birds are a good study species because they inhabit a wide range of land covers and have wide ranges of tolerance to disturbances; therefore they are a good indicator species of habitat quality for other species as well. The goal of this study was to assess habitat quality and develop a predictive species distribution model to predict occupancy for selected bird species and overall species richness based on the land cover matrix. The study species include the Eastern Kingbird and the Eastern Towhee. Species distribution models are useful in conservation planning because they can be used to designate protected areas and inform conservation efforts to adequately protect species. Data on habitat use on a small college campus in upstate South Carolina may also be able to inform habitat use in larger scale urban residential areas. Furman University is ranked among the most sustainable universities in the nation. Biodiversity and conservation are pillars of sustainability. Information on habitat qualities on campus and predictive distribution maps could help Furman improve conservation planning

Through the eyes of others - The social experiences of people with dementia: A systematic literature review and synthesis

Psychosocial models suggest that the lived experience of dementia is affected by interpersonal factors such as the ways in which others view, talk about, and behave toward the person with dementia. This review aimed to illuminate how informal, everyday interpersonal relationships are experienced by people with dementia within their social contexts. A systematic review of qualitative literature published between 1989 and May 2016 was conducted, utilizing the electronic databases PsycINFO, MEDLINE, and CINAHL-Complete. This was followed by a critical interpretative synthesis to understand how people with dementia perceive the attitudes, views, and reactions of other people toward them, and the subjective impact that these have. Four major themes were derived from the findings of the 23 included studies: being treated as an “other” rather than “one of us”; being treated as “lesser” rather than a full, valued member of society; the impact of others’ responses; and strategies to manage the responses of others. Thus, people with dementia can feel outcast and relegated, or indeed feel included and valued by others. These experiences impact upon emotional and psychological well-being, and are actively interpreted and managed by people with dementia. Experiences such as loss and diminishing identity have previously been understood as a direct result of dementia, with little consideration of interpersonal influences. This review notes that people with dementia actively engage with others, whose responses can foster or undermine social well-being. This dynamic relational aspect may contribute to emerging understandings of social health in dementia

Assessment of tibial fracture healing using dual energy X-ray absorptiometry

The assessment of fracture healing is largely a matter of clinical judgement, often based on observing x-rays showing the formation of bridging callus or obscuration of the fracture line and an impression of fracture stiffness obtained by manual loading. In circumstances where these assessment methods are compromised, for example in fractures stabilised using either external fixation or intramedullary nailing, the determination of healing can be problematic. Dual Energy X-ray Absorptiometry (DXA) provides a quick, non-invasive and quantitative method of measuring bone density, which could enable the change in mineral content at a healing site to be monitored. This study evaluated the viability of using DXA to assess the healing of tibial fractures stabilised using intramedullary nails and external fixators. Trials have been undertaken on a Lunar DPX-L scanner situated at South Cleveland Hospital, Middlesbrough. Aluminium and hydroxyapatite phantoms have been used to determine the accuracy, sensitivity and reproducibility of the DXA measurements. Small fracture gaps of less than 0.05 mm were detectable on both simulated transverse and oblique fractures. BMD values which one might expect at a fracture site could be accurately measured down to 0.16 g cm(^-2)14 Patients with tibial fractures (6 with intramedullary nails and 8 with external fixators) have been measured at 4 week intervals following trauma. The bone mineral density (BMD) at regions of interest along the fractured tibial shaft were compared to the non-fractured contra-lateral. Anatomical landmarks were used to relocate the regions of interest between scans and good reproducibility of results (coefficient of variation = 3.36 %) was obtained. After an initial fall in the first month, the BMD at the fracture site gradually increased to the original unfractured value by approximately the fifth month post-fracture. Proximal and distal to the trauma site there was a gradual decrease in BMD in all of the patients, which persisted for about 5 months post-fracture

"Any lady can do this without much trouble ...": class and gender in The dining room (1878)

Macmillan's "Art at Home" series (1876–83) was a collection of domestic advice manuals. Mentioned in every study of the late-nineteenth-century domestic interior, they have often been interpreted, alongside contemporary publications such as Charles Eastlake's Hints on Household Taste (1868), as indicators of late 1870s home furnishing styles. Mrs Loftie's The Dining Room (1878) was the series' fifth book and it considers one of the home's principal (and traditionally masculine) domestic spaces. Recent research on middle-class cultural practices surrounding food has placed The Dining Room within the tradition of Mrs Beeton's Household Management (1861); however, it is not a cookery book and hardly mentions dinners. Drawing upon unpublished archival sources, this paper charts the production and reception of The Dining Room, aiming to unravel its relationships with other contemporary texts and to highlight the difficulties of using it as historical evidence. While it offers fascinating insights into contemporary taste, class and gender, this paper suggests that, as an example of domestic design advice literature, it reveals far more about the often expedient world of nineteenth-century publishing practices

Critical reflections on designing product service systems

In response to unsustainability and the prospect of resource scarcity, lifestyles dominated by resource throughput are being challenged. This paper focuses on a design experiment that sought to introduce alternative resource consumption pathways in the form of product service systems (PSS) to satisfy household demand and reduce consumer durable household waste. In contrast to many other PSS examples this project did not begin with sustainability benefits, rather the preferences of supply and demand actors and the bounded geographical locations represented by two UK housing developments. The paper addresses the process through which the concept PSS were designed, selected and evaluated, alongside the practical and commercial parameters of the project. It proposes the need for a shift to further emphasize the importance of the design imperative in creating different PSS outcomes that reorganize relationships between people, resources and the environment

Local competition and metapopulation processes drive long-term seagrass-epiphyte population dynamics

It is well known that ecological processes such as population regulation and natural enemy interactions potentially occur over a range of spatial scales, and there is a substantial body of literature developing theoretical understanding of the interplay between these processes. However, there are comparatively few studies quantifying the long-term effects of spatial scaling in natural ecosystems. A key challenge is that trophic complexity in real-world biological communities quickly obscures the signal from a focal process. Seagrass meadows provide an excellent opportunity in this respect: in many instances, seagrasses effectively form extensive natural monocultures, in which hypotheses about endogenous dynamics can be formulated and tested. We present amongst the longest unbroken, spatially explict time series of seagrass abundance published to date. Data include annual measures of shoot density, total above-ground abundance, and associated epiphyte cover from five Zostera marina meadows distributed around the Isles of Scilly, UK, from 1996 to 2011. We explore empirical patterns at the local and metapopulation scale using standard time series analysis and develop a simple population dynamic model, testing the hypothesis that both local and metapopulation scale feedback processes are important. We find little evidence of an interaction between scales in seagrass dynamics but that both scales contribute approximately equally to observed local epiphyte abundance. By quantifying the long-term dynamics of seagrass-epiphyte interactions we show how measures of density and extent are both important in establishing baseline information relevant to predicting responses to environmental change and developing management plans. We hope that this study complements existing mechanistic studies of physiology, genetics and productivity in seagrass, whilst highlighting the potential of seagrass as a model ecosystem. More generally, this study provides a rare opportunity to test some of the predictions of ecological theory in a natural ecosystem of global conservation and economic val