Portrait of the Patient as a Young Man: An Exploration of the Use of Photographs in Hospital

The display of personal photographs in hospital is a common practice that has yet to be rigorously examined. The photographs displayed are subject to interpretation by the viewer and may lead to misunderstandings or miscommunication if clarification of meaning is not sought. This paper explores a range of possible meanings that the display of photographs in hospital may hold, based on a case study of a 15 year old boy hospitalised with a life threatening illness. Further research is needed into the actual meanings attributed to the display of photographs in hospital by patients and family members.     

Oral care of people with disability: a qualitative exploration of the views of nursing staff

This study aimed to identify influences, attitudes and actions of nursing staff in relation to oral care for people with disabilities. Individual in-depth interviews of twenty two nursing staff were conducted. Enabling and inhibiting factors in the reported attitudes, approaches and practices were identified. The main enabling factors were that nursing staff saw mouth care as part of their role and took an empathic and caring approach to its delivery. They aimed to make the residents socially acceptable, improve their self-esteem and make their mouths clean and breath fresher. Inhibiting factors were: a lack of training, time constraints associated with workload, and poor understanding of the processes causing dental disease. The study concludes that improvements in oral care by nursing staff can be encouraged by working with nurses'attitudes, values and beliefs. Once the desired behaviour change has occurred then the lack of knowledge can be addressed.     

Evolution of parental care in dart poison frogs (Amphibia: Anura: Dendrobatidae)

Dendrobatid frogs perform a unique mode of parental care, ranging from egg attendance and tadpole transport to tadpole feeding. It is hypothesized that a behaviour in which the egg attending parent remains with the cluch is the most primitive condition. In more advanced forms or parental care, the male is able to attend several clutches of eggs. Tadpole attendance and feeding, finally, started as deceit; the male induced the female to lay eggs into a bromeliad leaf axil already occupied by a larva. Costs and benefits of the different modes of parental care and possible alternative reproductive tactics are discussed.     

Social and reproductive behavior of three mouthbrooding cardinalfishes,Apogon doederleini,A. niger and A. notatus

Synopsis Social and reproductive behavior of three paternal mouthbrooding cardinalfishes (Apogonidae) were investigated in the shallow marine waters of Shirahama, Japan. The solitary species Apogon doederleini and A. niger bred in transient pairs, in which a male and female associated for only a few hours of each afternoon on less than 5 successive days. The prespawning behavior was the same as the courtship display on days prior to spawning. After spawning, egg-incubating males were usually left alone. The gregarious species Apogon notatus formed territorial lasting pairs, which resided at given sites from dawn to dusk on each day during a period of a month or more. After spawning, the egg-incubating male either continued to stay with his mate in the territory, or left it to enter into an aggregation. In the latter case, the female continued to reside in the territory, pairing with a new male whom she brought from an aggregation. It is suggested that in paternal apogonids the prolonged pair bond and territoriality should have developed only in gregarious species as secondary adaptation for reproductive success: to avoid conspecific interference during spawning.     

Functions and social consequences of infant–adult male interaction in a captive group of lowland gorillas (Gorilla gorilla gorilla)

The functions and social consequences of infant-adult male interaction in a captive group of lowland gorillas were evaluated. The two males repeatedly attempted to interact with the infant, the infant sometimes attempted to interact with the males, and the mother usually interrupted interactions between male and infant. Infant-directed actions by the two males frequently showed their interest in the infant and infrequently showed care giving toward her; their other infant-directed actions occurred near the time of excitement or of playful actions between adults. Male-directed actions by the infant frequently showed its interest in one male and infrequently showed care seeking from him. All infant-adult male interactions but one occurred in the less stimulating of the gorillas' two enclosures. Boredom and the mother's frequent thwarting of contact between a male and infant are suggested as influences on the males' interest in the infant. The data suggest that availability of interesting objects alleviated the boredom of captivity for males and thus dissuaded them from seeking stimulation which sometimes resulted in harmful behaviors toward the infant.     

The benefit to some minnows of spawning in the nests of other species

Synopsis Fishes that act as nest associates spawn simultaneously with nest-building hosts and then abandon their eggs. The proposed benefit for this behavior is increased brood survivorship, arising from the physical environment provided by the nest or the parental care provided by the host. Field and enclosure experiments indicated that associates benefit from the parental care provided by the host, and not from the physical environment provided by the nests of hosts. This information, along with the effect of nest association on host reproductive success, is necessary before the nature of this nesting symbiosis can be characterized.     

Utilidad y seguridad de los ingresos directos a una unidad hospitalaria de agudos de un servicio de geriatría valorados por atención geriátrica en residencias

Background and objectiveMore than half of institutionalized older people need a emergency department visit annually, with high resources consumption and higher risk of adverse events, due to high complexity. Direct admission to Acute Geriatric Unit (AGU), after geriatric consultant and nursing home medical team assessment, could be a safety and effective alternative to emergency department (ED) admission.MethodsRetrospective observational study of AGU patients admitted by Nursing Home Geriatric Team between January, 1st and December, 31st, 2021. Planned admissions and SARS-CoV-2 positive patients were excluded. Medical (sociodemographic, clinical, functional and cognitive) records and outcomes data (inpatient mortality, hospital and ED lenght of stay, transfer to ED and delirium within 48 h after admission, hospital discharge location) were collected.ResultsTwo hundred and six patients directly admitted, 101 through ED (N 307). 62.5% with Barthel index <40, 65% with dementia, 56.4% with Charlson index ≥3. Inpatient mortality was 14.6% in direct admission, 20.8% in ED referral group, p = 0.14. Hospital lenght of stay was 9.61 ± 6.01 days in direct admission, 11.22 ± 5.36 days in ED group, p = 0.02. 27.7% of patients with delirium in direct admission and 36.6% in ED group; only one patient was transferred to ED, within 48 h after admission.ConclusionsDirect admission is a safety and effective alternative to ED referral in institutionalized older people after geriatric assessment, due to no increased mortality, shorter length of stay and hospital cost reduction.     

Substance use disorders: a comprehensive update of classification,epidemiology, neurobiology,clinical aspects,treatment and prevention

Substance use disorders (SUDs) are highly prevalent and exact a large toll on individuals’ health, well-being, and social functioning. Long-lasting changes in brain networks involved in reward, executive function, stress reactivity, mood, and self-awareness underlie the intense drive to consume substances and the inability to control this urge in a person who suffers from addiction (moderate or severe SUD). Biological (including genetics and developmental life stages) and social (including adverse childhood experiences) determinants of health are recognized factors that contribute to vulnerability for or resilience against developing a SUD. Consequently, prevention strategies that target social risk factors can improve outcomes and, when deployed in childhood and adolescence, can decrease the risk for these disorders. SUDs are treatable, and evidence of clinically significant benefit exists for medications (in opioid, nicotine and alcohol use disorders), behavioral therapies (in all SUDs), and neuromodulation (in nicotine use disorder). Treatment of SUDs should be considered within the context of a Chronic Care Model, with the intensity of intervention adjusted to the severity of the disorder and with the concomitant treatment of comorbid psychiatric and physical conditions. Involvement of health care providers in detection and management of SUDs, including referral of severe cases to specialized care, offers sustainable models of care that can be further expanded with the use of telehealth. Despite advances in our understanding and management of SUDs, individuals with these conditions continue to be stigmatized and, in some countries, incarcerated, highlighting the need to dismantle policies that perpetuate their criminalization and instead develop policies to ensure support and access to prevention and treatment.     

Parental energy expenditure of the male three-spined stickleback

The energy expenditure of male three-spined sticklebacks performing parental care was 12·3 and 9·9 J g⁻¹ h⁻¹ estimated by respirometry and ration manipulation, respectively. The energy expenditure of caring male sticklebacks was significantly higher than for non-caring males.     

Alloparental feeding in Adélie penguins: why is it uncommon?

We investigated alloparental interactions and conditions which could facilitate or prevent the expression of alloparental behaviours in Adélie penguins (Pygoscelis adeliae), a long-lived seabird which nests in high-density colonies around Antarctica. Observation sessions were carried out during the crèche stage on 48 identified pairs and 50 identified chicks in a 217-nest subcolony. As the season progressed, young were fed less often by their own parents because these were increasingly absent from the breeding site and less responsive to their offspring’s solicitations. As a consequence, young and particularly those with a low body mass, coming from a two-chick brood, opted for gradually soliciting more from other adults to obtain food, preferentially those nesting in their direct vicinity. Unsuccessful breeders represented a low and constant part of the adult population and were not specifically solicited by unrelated young. Despite the increasing chick demand, only 4.1% (3 out of 73) of alloparental solicitations resulted in feeding, which is negligible compared to parental feeding. To investigate factors that could trigger the appearance of alloparental care, we carried out comparisons with king (Aptenodytes patagonicus) and emperor penguins (Aptenodytes forsteri) which represent the closest species for which data on alloparental behaviour were available. Our results show different trends to those observed in these species and three factors may explain the low occurrence of alloparental behaviour in Adélie penguins: (1) the low and constant proportion of unsuccessful breeders, (2) the absence of chick selectivity towards unsuccessful breeders, and (3) the late period of chick accessibility for potential alloparents.