'Conditional candour' and 'knowing me': an interpretive description study on patient preferences for physician behaviours during end-of-life communication

OBJECTIVE: To understand patients' preferences for physician behaviours during end-of-life communication.

METHODS: We used interpretive description methods to analyse data from semistructured, one-on-one interviews with patients admitted to general medical wards at three Canadian tertiary care hospitals. Study recruitment took place from October 2012 to August 2013. We used a purposive, maximum variation sampling approach to recruit hospitalised patients aged ≥55 years with a high risk of mortality within 6-12 months, and with different combinations of the following demographic variables: race (Caucasian vs non-Caucasian), gender and diagnosis (cancer vs non-cancer).

RESULTS: A total of 16 participants were recruited, most of whom (69%) were women and 70% had a non-cancer diagnosis. Two major concepts regarding helpful physician behaviour during end-of-life conversations emerged: (1) 'knowing me', which reflects the importance of acknowledging the influence of family roles and life history on values and priorities expressed during end-of-life communication, and (2) 'conditional candour', which describes a process of information exchange that includes an assessment of patients' readiness, being invited to the conversation, and sensitive delivery of information.

CONCLUSIONS: Our findings suggest that patients prefer a nuanced approach to truth telling when having end-of-life discussions with their physician. This may have important implications for clinical practice and end-of-life communication training initiatives.

Climatic signals in the life histories of insects:the distribution and abundance of heather psyllids (Strophingia spp.) in the UK

1. The population density and age structure of two species of heather psyllid Strophingia ericae and Strophingia cinereae, feeding on Calluna vulgaris and Erica cinerea, respectively, were sampled using standardized methods at locations throughout Britain. Locations were chosen to represent the full latitudinal and altitudinal range of the host plants.

2. The paper explains how spatial variation in thermal environment, insect life-history characteristics and physiology, and plant distribution, interact to provide the mechanisms that determine the range and abundance of Strophingia spp.

3. Strophingia ericae and S. cinereae, despite the similarity in the spatial distribution patterns of their host plants within Britain, display strongly contrasting geographical ranges and corresponding life-history strategies. Strophingia ericae is found on its host plant throughout Britain but S. cinereae is restricted to low elevation sites south of the Mersey-Humber line and occupies only part of the latitudinal and altitudinal range of its host plant. There is no evidence to suggest that S. ericae has reached its potential altitudinal or latitudinal limit in the UK, even though its host plant appears to reach its altitudinal limit.

4. There was little difference in the ability of the two Strophingia spp. to survive shortterm exposure to temperatures as low as - 15 degrees C and low winter temperatures probably do not limit distribution in S. cinereae.

5. Population density of S. ericae was not related to altitude but showed a weak correlation with latitude. The spread of larval instars present at a site, measured as an index of instar homogeneity, was significantly correlated with a range of temperature related variables, of which May mean temperature and length of growing season above 3 degrees C (calculated using the Lennon and Turner climatic model) were the most significant. Factor analysis did not improve the level of correlation significantly above those obtained for single climatic variables. The data confirmed that S. ericae has a I year life cycle at the lowest elevations and a 2 year life cycle at the higher elevations. However, there was no evidence, as previously suggested, for an abrupt change from a one to a 2 year life cycle in S. ericae with increasing altitudes or latitudes.

6. By contrast with S. ericae, S. cinereae had an obligatory 1 year life cycle, its population decreased with altitude and the index of instar homogeneity showed little correlation with single temperature variables. Moreover, it occupied only part of the range of its host plant and its spatial distribution in the UK could be predicted with 96% accuracy using selected variables in discriminant analysis.

7. The life histories of the congeneric heather psyllids reflect adaptations that allow them to exploit host plants with different distributions in climatic and thereby geographical space. Strophingia ericae has the flexible life history that enables it to exploit C. vulgaris throughout its European boreal temperate range. Strophingia cinereae has a less flexible life history and is adapted for living on an oceanic temperate host. While the geographic ranges of the two Strophingia spp. overlap within the UK, the psyllids appear to respond differently to variation in their thermal environment.

Experiences with cultural capital in education : exploring the educational life stories of first-generation postsecondary students

This study used a life history research design to explore first-generation university students' educational life stories and experiences with cultural capital. The project sought to examine how 3 first-generation university students experience cultural capital that is privileged in Ontario's education system and how the interactions between capital acquired through experiences within the home and school and capital privileged by the education system affect these students' educational experiences and perceptions. Using Pierre Bourdieu's (1984; 1986) theory of cultural capital as a framework, 3 firstgeneration, first-year university students participated in two 1- to 2-hour interviews. A focus on each participant's experiences with culture, capital, and education revealed themes corresponding to navigating, utilizing, and confronting familial, institutional, economic, and embodied forms of cultural capital. The study highlights the importance of recognizing how cultural capital influences the education system and how firstgeneration students can recreate normative pathways and achieve academic success despite challenges posed by the cultural capital privileged within the education system. Given cultural capital's effect on academic success, understanding first-generation students' educational life stories sheds light on the complex challenges facing students who confront and deal with privileged culture in the education system.

Costs of Reproduction in Breeding Female Mallards: Predation Risk during Incubation Drives Annual Mortality

The effort expended on reproduction may entail future costs, such as reduced survival or fecundity, and these costs can have an important influence on life-history optimization. For birds with precocial offspring, hypothesized costs of reproduction have typically emphasized nutritional and energetic investments in egg formation and incubation. We measured seasonal survival of 3856 radio-marked female Mallards (Anas platyrhynchos) from arrival on the breeding grounds through brood-rearing or cessation of breeding. There was a 2.5-fold direct increase in mortality risk associated with incubating nests in terrestrial habitats, whereas during brood-rearing when breeding females occupy aquatic habitats, mortality risk reached seasonal lows. Mortality risk also varied with calendar date and was highest during periods when large numbers of Mallards were nesting, suggesting that prey-switching behaviors by common predators may exacerbate risks to adults in all breeding stages. Although prior investments in egg laying and incubation affected mortality risk, most relationships were not consistent with the cost of reproduction hypothesis; birds with extensive prior investments in egg production or incubation typically survived better, suggesting that variation in individual quality drove both relationships. We conclude that for breeding female Mallards, the primary cost of reproduction is a fixed cost associated with placing oneself at risk to predators while incubating nests in terrestrial habitats.

Local adaptation in moss life histories: population-level variation and a reciprocal transplant experiment

We examine the extent of population-level differentiation in life history traits of Pogonatum aloides, Polytrichum commune and Polytrichum juniperinum (Polytrichaceae) between upland and lowland localities within Britain. Reciprocal transplant studies are used to estimate the relative importance of genetic versus environmental effects on observed differences. We demonstrate significant life history differentiation between moss populations, and show that at least some of these are genetically determined, although environment and phenotypic plasticity are also significant components of the observed variation. The transplant experiments indicate divergence among populations in plasticity of male reproductive effort and of investment in vegetative shoots by females. Two tradeoffs are identified; one between the number and the size of spores, and the second between reproduction by spores versus vegetative reproduction. The patterns of life history variation observed between populations of Polytrichum juniperinum are consistent with selection along these implied tradeoff curves, and we propose that they reflect selective pressures arising from the spatial and demographic distribution of mortality at upland versus lowland sites. The results underscore the need for more studies of intra-specific life history variation in mosses.

Effects of body size and lifestyle on evolution of mammal life histories

It has recently been proposed that life-history evolution is subject to a fundamental size-dependent constraint. This constraint limits the rate at which biomass can be produced so that production per unit of body mass is inevitably slower in larger organisms than in smaller ones. Here we derive predictions for how changes in body size and production rates evolve in different lifestyles subject to this constraint. Predictions are tested by using data on the mass of neonate tissue produced per adult per year in 637 placental mammal species and are generally supported. Compared with terrestrial insectivores with generalized primitive traits, mammals that have evolved more specialized lifestyles have divergent massspecific production rates: (i) increased in groups that specialize on abundant and reliable foods: grazing and browsing herbivores (artiodactyls, lagomorphs, perissoclactyls, and folivorous rodents) and flesh-eating marine mammals (pinnipeds, cetaceans); and (ii) decreased in groups that have lifestyles with reduced death rates: bats, primates, arboreal, fossorial, and desert rodents, bears, elephants, and rhinos. Convergent evolution of groups with similar lifestyles is common, so patterns of productivity across mammalian taxa reflect both ecology and phylogeny. The overall result is that groups with different lifestyles have parallel but offset relationships between production rate and body size. These results shed light on the evolution of the fast-slow life-history continuum, suggesting that variation occurs along two axes corresponding to body size and lifestyle.

Evaluation of malacosporean life cycles through transmission studies

Myxozoans, belonging to the recently described Class Malacosporea, parasitise freshwater bryozoans during at least part of their life cycle, but no complete malacosporean life cycle is known to date. One of the 2 described malacosporeans is Tetracapsuloides bryosalmonae, the causative agent of salmonid proliferative kidney disease. The other is Buddenbrockia plumatellae, so far only found in freshwater bryozoans. Our investigations evaluated malacosporean life cycles, focusing on transmission from fish to bryozoan and from bryozoan to bryozoan. We exposed bryozoans to possible infection from: stages of T bryosalmonae in fish kidney and released in fish urine; spores of T bryosalmonae that had developed in bryozoan hosts; and spores and sac stages of B. plumatellae that had developed in bryozoans. Infections were never observed by microscopic examination of post-exposure, cultured bryozoans and none were detected by PCR after culture. Our consistent negative results are compelling: trials incorporated a broad range of parasite stages and potential hosts, and failure of transmission across trials cannot be ascribed to low spore concentrations or immature infective stages. The absence of evidence for bryozoan to bryozoan transmissions for both malacosporeans strongly indicates that such transmission is precluded in malacosporean life cycles. Overall, our results imply that there may be another malacosporean host which remains unidentified, although transmission from fish to bryozoans requires further investigation. However, the highly clonal life history of freshwater bryozoans is likely to allow both long-term persistence and spread of infection within bryozoan populations, precluding the requirement for regular transmission from an alternate host.

Life histories of music service histories, the past in inductees' present

This article discusses inductee music service teachers (to 25 years of age). It explores how their lives, as perceived, shape current identities in teaching and result in several career problems. Respondents were drawn from a comprehensive life history study of 28 Local Education Authority employees. Of this larger cohort, four were age 25 years and below, and the remaining 24 teachers made retrospective comments. Data were collected and analysed between October 2002 and March 2004. Principal findings suggest that schooling failed to address these educators' needs as musical learners; key childhood experiences were external of schools. This often resulted in an idealistic trajectory, in teenage years, towards an occupation as a performer. An occupation in music education was entirely disregarded. Consequently, inductees now consider training experiences an inappropriate platform for their professional lives. Managing group teaching and children's behaviour engenders considerable anxiety. Music service work is also deemed a transient state of affairs. There are implications for training, retention and professional development.

Life histories of academics who become heads of department: socialisation, identity and career trajectory

Although the role of the academic head of department (HoD) has always been important to university management and performance, an increasing significance given to bureaucracy, academic performance and productivity, and government accountability has greatly elevated the importance of this position. Previous research and anecdotal evidence suggests that as academics move into HoD roles, usually with little or no training, they experience a problem of struggling to adequately manage key aspects of their role. It is this problem – and its manifestations – that forms the research focus of this study. Based on the research question, “What are the career trajectories of academics who become HoDs in a selected post-1992 university?” the study aimed to achieve greater understanding of why academics become HoDs, what it is like being a HoD, and how the experience influences their future career plans. The study adopts an interpretive approach, in line with social constructivism. Edited topical life history interviews were undertaken with 17 male and female HoDs, from a range of disciplines, in a post-1992 UK university. These data were analysed using coding, categorisation and theme formation techniques and developing profiles of each of the respondents. The findings from this study suggest that academics who become HoDs not only need the capacity to assume a range of personal and professional identities, but need to regularly adopt and switch between them. Whether individuals can successfully balance and manage these multiple identities, or whether they experience major conflicts and difficulties within or between them, greatly affects their experiences of being a HoD and may influence their subsequent career decisions. It is claimed that the focus, approach and analytical framework - based on the interrelationships between the concepts of socialisation, identity and career trajectory - provide a distinct and original contribution to knowledge in this area. Although the results of this study cannot be generalised, the findings may help other individuals and institutions move towards a firmer understanding of the academic who becomes HoD - in relation to theory, practice and future research.

Anthropogenic natal environmental effects on life histories in a wild bird population

Recent work suggests that the environment experienced in early life can alter life histories in wild populations [1, 2, 3, 4 and 5], but our understanding of the processes involved remains limited [6 and 7]. Since anthropogenic environmental change is currently having a major impact on wild populations [8], this raises the possibility that life histories may be influenced by human activities that alter environmental conditions in early life. Whether this is the case and the processes involved remain unexplored in wild populations. Using 23 years of longitudinal data on the Mauritius kestrel (Falco punctatus), a tropical forest specialist, we found that females born in territories affected by anthropogenic habitat change shifted investment in reproduction to earlier in life at the expense of late life performance. They also had lower survival rates as young adults. This shift in life history strategy appears to be adaptive, because fitness was comparable to that of other females experiencing less anthropogenic modification in their natal environment. Our results suggest that human activities can leave a legacy on wild birds through natal environmental effects. Whether these legacies have a detrimental effect on populations will depend on life history responses and the extent to which these reduce individual fitness.

Agriculture and the life histories of Mauritius kestrels

Habitat modification for agriculture is one of the greatest current threats to global biodiversity. Studies show large-scale population declines and short-term demographic impacts, but knowledge of the long-term effects of agriculture on individuals remains poor. This thesis examines the short- and long-term impact of agriculture on a reintroduced population of the Mauritius kestrel Falco punctatus, a tropical forest-dwelling raptor endemic to the island of Mauritius, that also utilises agricultural habitats. This population is a particularly appropriate model system, because complete life history data exists for individuals over a 22-year period, alongside detailed habitat and climate data. Agriculture has a short-term detrimental effect on Mauritius kestrel breeding success by exacerbating the seasonal decline in fledgling production. This is partly driven by the habitat-specific composition of the prey community that kestrels exploit to feed their chicks. The fledglings from agricultural territories tend to recruit in agricultural territories. This is largely due to poor natal dispersal and fine-scale spatial autocorrelation in the habitat matrix. Breeders do not respond to agriculture in the breeding territory by dispersing, unless the pair bond is broken. Therefore, individuals originating in agricultural territories tend to recruit, and remain in, agricultural territories throughout their lives. In addition to this, females from agricultural natal territories have shorter lifespans, schedule their peak reproductive output earlier in life, and exhibit more rapid senescence than non-agricultural females. The combination of this long-term effect and the adult experience of agriculture imposed by life history and environmental constraints, leads to a lower mean lifetime reproductive rate compared to females originating in non-agricultural habitats. These results demonstrate that agriculture experienced in early life has a lifelong effect on individuals. The effects can persist in time and space, with potentially delayed effects on population dynamics. These findings are important for understanding species’ responses to agricultural expansion.

Fertility life table of Trichogramma pretiosum and Trichogramma acacioi (Hymenoptera : Trichogrammatidae) on Sitotroga cerealella (Lepidoptera : Gelechiidae) eggs at different constant temperatures

Fertility life tables were developed for both Trichogramma pretiosum and Trichogramma acacioi reared on Sitotroga cerealella eggs as an alternative host at five different temperatures. The egg parasitoids were first collected from Nipteria panacea eggs, a lepidopterous pest of avocado. Egg parasitoid females were individualized in small glass vials along with 40 eggs of the host during 24 h for parasitization. For evaluation of the parasitism capacity, a similar procedure was adopted, but cardboards with eggs were replaced every day. The net reproductive rate (Ro), intrinsic rate of increase (rm), finite rate of increase (lambda), and mean generation time (T) were estimated. Temperature affected all parameters for both Trichogramma species. The highest fecundity for both species was observed at 25degreesC. Extreme temperatures such as 15degreesC or 35degreesC negatively affect the development rate of both species.

Mathematics teaching life histories in the study of teachers' perceptions of change

The aim of this paper is to discuss teachers' perceptions of change in their thought and/or practice over time and their perceptions of what kind of experiences or challenges might have influenced those changes. Two mathematics teaching life histories of Brazilian teachers are examined, considering a context of curriculum development in the state of São Paulo, Brazil. Reflection on teachers' thought and practice and interest in their own development, including interest in their own learning of mathematics, seemed to be the most important internal aspects influencing change and development. Close support seemed to be the most important external aspect. The retrospective analysis put a good face on personal change and development. (C) 2000 Elsevier B.V. Ltd. All rights reserved.

Life mode of in situ Conularia in a Middle Devonian epibole

Exceptionally abundant specimens of Conularia aff. desiderata Hall occur in multiple marine obrution deposits, in a single sixth-order parasequence composed of argillaceous and silty very fine sandstone, in the Otsego Member of the Mount Marion Formation (Middle Devonian, Givetian) in eastern New York State, USA. Associated fossils consist mostly of rhynchonelliform brachiopods but also include bivalve molluscs, orthoconic nautiloids, linguliform brachiopods and gastropods. Many of the brachiopods, bivalve molluscs and conulariids have been buried in situ. Conulariids buried in situ are oriented with their aperture facing obliquely upward and with their long axis inclined at up to 87degree to bedding. Most specimens are solitary, but some occur in V-like pairs or in radial clusters consisting of three specimens, with the component specimens being about equally long or (less frequently) substantially different in length. The compacted apical end of Conularia buried in situ generally rests upon argillaceous sandstone. With one possible exception, none of the examined specimens terminates in a schott (apical wall), and internal schotts appear to be absent. The apical ends of specimens in V-like pairs and radial clusters show no direct evidence of interconnection of their periderms. The apical, middle or apertural region of some inclined specimens abuts or is in close lateral proximity to a recumbent conulariid or to one or more spiriferid brachiopods, some of which have been buried in their original life orientation. The azimuthal bearings of Conularia and nautiloid long axes and the directions in which conulariids open are nonrandom, with conulariids being preferentially aligned between 350 and 50degree and with their apertural end facing north-east, and nautiloids being preferentially aligned between 30 and 70degree. Otsego Member Conularia were erect or semi-erect, epifaunal or partially infaunal animals, the apical end of which rested upon very fine bottom sediment. The origin of V-like pairs and radial clusters remains enigmatic, but it is probable that production of schotts was not a regular feature of this animal's life history. Finally, conulariids and associated fauna were occasionally smothered by distal storm deposits, under the influence of relatively weak bottom currents. © The Palaeontological Association.