Designing a questionnaire to gather carer input to pain assessment for hospitalized people with dementia

We describe development of a questionnaire to elicit pain symptoms and experience, for use by people with dementia or their carers, at hospital admission. The questionnaire provided contextual information to support professionals’ use of the Abbey Pain Scale, a validated tool used by nursing staff internationally. Appropriate information and physical design were required in order, not only to create an approachable questionnaire for patients and carers, but also to ensure fit with hospital processes. Fit with hospital process had significant influence on the final form of the questionnaire, compromising some aspects of design for patients and carers, but this compromise was considered essential to ensure pain management procedures were supplemented by wider, contextual information.

Historic environments and tourism: Improving access for disabled people

Historic environments and buildings are valued and valuable features of the UK tourism sector, as visitor attractions and as holiday accommodation. Keeping historic environments in economic use is crucial to their conservation, but they date from eras when access for disabled people was not a consideration. Part III of the Disability Discrimination Act 1995 (the DDA) took effect on 1 October 2004 and requires service providers to make reasonable building adjustments to remove physical barriers to disabled access. This independent scoping study by the College of Estate Management, sponsored by Marsh Limited and The Mercers' Company, explores progress in making historic environments accessible to disabled people through an examination of UK policy, literature and case studies in South Oxfordshire and London. The report findings are relevant for property and built environment professionals, business managers and all those involved with historic environments that are used for tourism.

People or machines? Assessing the impacts of smart meters and load controllers in Italian office spaces

Government initiatives in several developed and developing countries to roll-out smart meters call for research on the sustainability impacts of these devices. In principle smart meters bring about higher control over energy theft and lower consumption, but require a high level of engagement by end-users. An alternative consists of load controllers, which control the load according to pre-set parameters. To date, research has focused on the impacts of these two alternatives separately. This study compares the sustainability impacts of smart meters and load controllers in an occupied office building in Italy. The assessment is carried out on three different floors of the same building. Findings show that demand reductions associated with a smart meter device are 5.2% higher than demand reductions associated with the load controller.

Emotions and the habitus: Young people with socio-emotional differences (re)producing social, emotional and cultural capital in family and leisure space-times

In this paper we explore the importance of emotionally inter-dependent relationships to the functioning of embodied social capital and habitus. Drawing upon the experiences of young people with socio-emotional differences, we demonstrate how emotionally inter-dependent and relatively nurturing relationships are integral to the acquisition of social capital and to the co-construction and embodiment of habitus. The young people presented in this paper often had difficulties in forging social relationships and in acquiring symbolic and cultural capital in school spaces. However, we outline how these young people (re)produce and embody alternative kinds of habitus, based on emotionally reciprocal relationships forged through formal and informal leisure activities and familial and fraternal social relationships. These alternative forms of habitus provide sites of subjection, scope for acquiring social and cultural capital and a positive sense of identity in the face of problematic relations and experiences in school spaces.

Making electronics more accessible to people with learning disabilities

We extended 'littleBits' electronic components by attaching them to a larger base that was designed to help make them easier to pick up and handle, and easier to assemble into circuits for people with learning disabilities. A pilot study with a group of students with learning disabilities was very positive. There were fewer difficulties in assembling the components into circuits, and problems such as attempting to connect them the wrong way round or the wrong way up were eliminated completely.

The effect of macro and micro-nutrient fortification of biscuits on their sensory properties and on hedonic liking of older people

BACKGROUND: Under-nutrition in older adults is widespread. Oral nutritional supplement beverages (ONS) are prescribed, yet consumption by older people is often insufficient. A variety of supplement formats may improve nutrient intake. This study developed protein and micro-nutrient fortified biscuits and evaluated their sensory attributes and liking by older people. Two micro-nutrient strategies were taken, to match typical ONS and to customise to the needs of older people. RESULTS: Oat biscuits and gluten-free biscuits developed contained over 12% protein and over 460 kcal 100 g-1 . Two small (40 g) biscuits developed to match ONS provided approximately 40% of an ONS portion of micro-nutrients and 60% of macro-nutrients; however, the portion size was considered realistic whereas the average ONS portion (200 mL) is excessive. Biscuits developed to the needs of older adults provided, on average, 18% of the reference nutrient intake of targeted micro-nutrients. Sensory characteristics were similar between biscuits with and without micro-nutrient fortification, leading to no differences in liking. Fortified oat biscuits were less liked than commercial oat biscuits, partly attributed to flavour imparted by whey protein fortification. CONCLUSION: Macro- and micro-nutrient fortification of biscuits could provide an alternative fortified snack to help alleviate malnutrition in older adults.

Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings

Objective: Fecal loading, cognitive impairment, loose stools, functional disability, comorbidity and anorectal incontinence are recognized as factors contributing to loss of fecal continence in older adults. The objective of this project was to assess the relative distribution of these factors in a variety of settings along with the outcome of usual management. Methods: One hundred and twenty adults aged 65 years and over with fecal incontinence recruited by convenience sampling from four different settings were studied. They were either living at home or in a nursing home or receiving care on an acute or rehabilitation elderly care ward. A structured questionnaire was used to elicit which factors associated with fecal incontinence were present from subjects who had given written informed consent or for whom assent for inclusion in the study had been obtained. Results: Fecal loading (Homes 6 [20%]; Acute care wards 17 [57%]; Rehabilitation wards 19 [63%]; Nursing homes 21 [70%]) and functional disability (Homes 5 [17%]; Acute care wards 25 [83%]; Rehabilitation wards 25 [83%]; Nursing homes 20 [67%]) were significantly more prevalent in the hospital and nursing home settings than in those living at home (P < 0.01). Loose stools were more prevalent in the hospital setting than in the other settings (Homes 11 [37%]; Acute care wards 20 [67%]; Rehabilitation wards 17 [57%]; Nursing homes 6 [20%]) (P < 0.01). Cognitive impairment was significantly more common in the nursing home than in the other settings (Nursing homes 26 [87%], Homes 5 [17%], Acute care wards 13 [43%], Rehabilitation wards 14 [47%]) (P < 0.01). Loose stools were the most prevalent factor present at baseline in 13 of the 19 (68%) subjects whose fecal incontinence had resolved at 3 months. Conclusion: The distribution of the factors contributing to fecal incontinence in older people living at home differs from those cared for in nursing home and hospital wards settings. These differences need to be borne in mind when assessing people in different settings. Management appears to result in a cure for those who are not significantly disabled with loose stools as a cause for their fecal incontinence, but this would need to be confirmed by further research.

Memory suppression can help people “unlearn” behavioral responses—but only for nonemotional memories

When encountering reminders of memories that we prefer not to think about, we often try to exclude those memories from awareness. Past studies have revealed that such suppression attempts can reduce the subsequent recollection of unwanted memories. In the present study, we examined whether the inhibitory effects extend even to associated behavioral responses. Participants learned cue–target pairs for emotional and nonemotional targets and were additionally trained in behavioral responses for each cue. Afterward, they were shown the cues and instructed either to think or to avoid thinking about the targets without performing any behaviors. In a final test phase, behavioral performance was tested for all of the cues. When the targets were neutral, participants’ attempts to avoid retrieval reduced accuracy and increased reaction times in generating behavioral responses associated with cues. By contrast, behavioral performance was not affected by suppression attempts when the targets were emotional. These results indicate that controlling unwanted recollection is powerful enough to inhibit associated behavioral responses—but only for nonemotional memories.

Leader characteristics and styles in the SMEs of the People's Republic of China during the global financial crisis

This empirical study explores successful views and characteristics of leaders and employees in the SMEs of the People's Republic of China during the global financial crisis.

It is always on your mind: experiences and perceptions of falling of older people and their carers and the potential of a mobile falls detection device

Background. Falls and fear of falling present a major risk to older people as both can affect their quality of life and independence. Mobile assistive technologies (AT) fall detection devices may maximise the potential for older people to live independently for as long as possible within their own homes by facilitating early detection of falls. Aims. To explore the experiences and perceptions of older people and their carers as to the potential of a mobile falls detection AT device. Methods. Nine focus groups with 47 participants including both older people with a range of health conditions and their carers. Interviews were audio recorded, transcribed verbatim, and thematically analysed. Results. Four key themes were identified relating to participants’ experiences and perceptions of falling and the potential impact of a mobile falls detector: cause of falling, falling as everyday vulnerability, the environmental context of falling, and regaining confidence and independence by having a mobile falls detector. Conclusion. The perceived benefits of a mobile falls detector may differ between older people and their carers. The experience of falling has to be taken into account when designing mobile assistive technology devices as these may influence perceptions of such devices and how older people utilise them.

The interaction between the physical environments and people

Buildings affect people in various ways. They can help us to work more effectively; they also present a wide range of stimuli for our senses to react to. Intelligent buildings are designed to be aesthetic in sensory terms not just visually appealing but ones in which occupants experience delight, freshness, airiness, daylight, views out and social ambience. All these factors contribute to a general aesthetic which gives pleasure and affects one’s mood. If there is to be a common vision, it is essential for architects, engineers and clients to work closely together throughout the planning, design, construction and operational stages which represent the conception, birth and life of the building. There has to be an understanding of how patterns of work are best suited to a particular building form served by appropriate environmental systems. A host of technologies are emerging that help these processes, but in the end it is how we think about achieving responsive buildings that matters. Intelligent buildings should cope with social and technological changes and also be adaptable to short-term and long-term human needs. We live through our senses. They rely on stimulation from the tasks we are focused on; people around us but also the physical environment. We breathe air and its quality affects the olfactory system; temperature is felt by thermoreceptors in the skin; sound enters our ears; the visual scene is beheld by our eyes. All these stimuli are transmitted along the sensory nervous system to the brain for processing from which physiological and psychological reactions and judgments are formed depending on perception, expectancies and past experiences. It is clear that the environmental setting plays a role in this sensory process. This is the essence of sensory design. Space plays its part as well. The flow of communication is partly electronic but also largely by people meeting face to face. Our sense of space wants different things at different times. Sometimes privacy but other times social needs have to be satisfied besides the organizational requirement to have effective human communications throughout the building. In general if the senses are satisfied people feel better and work better.