Lighting the homes of people who are visually impaired

An extended research project, funded by the Thomas Pocklington Trust, and carried out by the Research Group for Inclusive Environments (RGIE) at The University of Reading, has examined the lighting found in the homes of people who are visually impaired (VIP). This paper will summarise the results of this substantive study. All the surveyed homes have been occupied by people with sight loss, some of the dwellings were shared with sighted partners. There are several safety issues concerning domestic lighting where inadequate provision may contribute to the incidence of personal injuries occurring in the home. Qualitative and quantitative data from questionnaires, photometric surveys and faceto- face interviews have been obtained from 57 homes. The nature and extent of the visual impairment of each study participant has been identified. This paper will identify important findings from the study, including: a range of areas and tasks within the home that visually impaired people find inadequately lit; the variability of illuminance provided for task lighting and general lighting; and how effective visually impaired people find a selection different lighting systems to those that they commonly use. The research team are able to offer preliminary design guidance for lighting the homes of people who are visually impaired. These will be summarised in the paper.

Fecal microbiota in patients receiving enteral feeding are highly variable and may be altered in those who develop diarrhea

Background: The pathogenesis of diarrhea in patients receiving enteral feeding includes colonic water secretion, antibiotic prescription, and enteropathogenic colonization, each of which involves an interaction with the gastrointestinal microbiota. Objective: The objective was to investigate temporal changes in the concentrations of fecal microbiota and short-chain fatty acids (SCFAs) in patients starting 14-d of enteral feeding and to compare these changes between patients who do and do not develop diarrhea. Design: Twenty patients starting exclusive nasogastric enteral feeding were monitored for 14 d. Fecal samples were collected at the start, middle, and end of this period and were analyzed for major bacterial groups by using culture independent fluorescence in situ hybridization and for SCFAs by using gas-liquid chromatography. Results: Although no significant changes in fecal microbiota or SCFAs were observed during enteral feeding, stark alterations occurred within individual patients. Ten patients (50%) developed diarrhea, and these patients had significantly higher concentrations of clostridia (P = 0.026) and lower concentrations (P = 0.069) and proportions (P = 0.029) of bifidobacteria. Patients with and without diarrhea had differences in the proportion of bifidobacteria (median: 0.4% and 3.7%; interquartile range: 0.8 compared with 4.3; P = 0.035) and clostridia (median: 10.4% and 3.7%; interquartile range: 14.7 compared with 7.0; P = 0.063), respectively, even at the start of enteral feeding. Patients who developed diarrhea had higher concentrations of total fecal SCFAs (P = 0.044), acetate (P = 0.029), and butyrate (P = 0.055). Conclusion: Intestinal dysbiosis occurs in patients who develop diarrhea during enteral feeding and may be involved in its pathogenesis. Am J Clin Nutr 2009; 89: 240-7.

Who knows best? Awareness of divided attention difficulty in a neurological rehabilitation setting

Objective: To explore whether patients relearning to walk after acquired brain injury and showing cognitive-motor interference were aware of divided attention difficulty; whether their perceptions concurred with those of treating staff. Design: Patients and neurophysiotherapists (from rehabilitation and disabled wards) completed questionnaires. Factor analyses were applied to responses. Correlations between responses, clinical measures and experimental decrements were examined. Results: Patient/staff responses showed some agreement; staff reported higher levels of perceived difficulty; responses conformed to two factors. One factor (staff/patients alike) reflected expectations about functional/motor status and did not correlate with decrements. The other factor (patients) correlated significantly with dual-task motor decrement, suggesting some genuine awareness of difficulty (cognitive performance prioritized over motor control). The other factor (staff) correlated significantly with cognitive decrement (gait prioritized over sustained attention). Conclusions: Despite some inaccurate estimation of susceptibility; patients and staff do exhibit awareness of divided attention difficulty, but with a limited degree of concurrence. In fact, our results suggest that patients and staff may be sensitive to different aspects of the deficit. Rather than 'Who knows best?', it is a question of 'Who knows what?.

Knowing who likes who: The early developmental basis of coalition understanding

Group biases based on broad category membership appear early in human development. However, like many other primates humans inhabit social worlds also characterised by small groups of social coalitions which are not demarcated by visible signs or social markers. A critical cognitive challenge for a young child is thus how to extract information concerning coalition structure when coalitions are dynamic and may lack stable and outwardly visible cues to membership. Therefore, the ability to decode behavioural cues of affiliations present in everyday social interactions between individuals would have conferred powerful selective advantages during our evolution. This would suggest that such an ability may emerge early in life, however, little research has investigated the developmental origins of such processing. The present paper will review recent empirical research which indicates that in the first 2 years of life infants achieve a host of social-cognitive abilities that make them well adapted to processing coalition-affiliations of others. We suggest that such an approach can be applied to better understand the origins of intergroup attitudes and biases. Copyright © 2010 John Wiley & Sons, Ltd.