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1.
Health Expect ; 27(2): e14012, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38488441

RESUMEN

Patient and public involvement and engagement (PPIE) is critically important in healthcare research. A useful starting point for researchers to understand the scope of PPIE is to review the definition from the National Institute for Health and Care Research (NIHR) as, 'research being carried out "with" or "by" members of the public rather than "to", "about" or "for" them'. PPIE does not refer to participation in research, but to actively shaping its direction. The 'Effectiveness of a decision support tool to optimise community-based tailored management of sleep for people living with dementia or mild cognitive impairment (TIMES)' study is funded through the NIHR programme grant for applied research. TIMES has thoroughly embraced PPIE by ensuring the person's voice is heard, understood, and valued. This editorial showcases how the TIMES project maximised inclusivity, and we share our experiences and top tips for other researchers. We base our reflections on the six key UK standards for public involvement; Inclusive Opportunities, Working Together, Support and Learning, Communications, Impact and Governance. We present our work, which had been co-led by our PPIE leads, academics and partners including, together in dementia everyday, Innovations in Dementia, The UK Network of Dementia Voices (Dementia Engagement & Empowerment Project) and Liverpool Chinese Wellbeing. We have a Lived Experience Advisory Forum on Sleep, which includes people with dementia, family carers, representatives of the South Asian Community and the Chinese community.


Asunto(s)
Pueblo Asiatico , Demencia , Humanos , Comunicación , Investigación sobre Servicios de Salud , Aprendizaje , Reino Unido
2.
Aging Ment Health ; : 1-9, 2023 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-38079334

RESUMEN

OBJECTIVES: This study aims to investigate the impact of self and partner experiences of loneliness and social isolation on life satisfaction in people with dementia and their spousal carers. METHODS: We used data from 1042 dementia caregiving dyads in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme cohort. Loneliness was measured using the six-item De Jong Gierveld loneliness scale and social isolation using the six-item Lubben Social Network Scale. Data were analysed using the Actor-Partner Interdependence Model framework. RESULTS: Self-rated loneliness was associated with poorer life satisfaction for both people with dementia and carers. The initial partner effects observed between the loneliness of the carer and the life satisfaction of the person with dementia and between social isolation reported by the person with dementia and life satisfaction of the carer were reduced to nonsignificance once the quality of the relationship between them was considered. DISCUSSION: Experiencing greater loneliness and social isolation is linked with reduced life satisfaction for people with dementia and carers. However, having a positive view of the quality of the relationship between them reduced the impact of loneliness and social isolation on life satisfaction. Findings suggest the need to consider the experiences of both the person with dementia and the carer when investigating the impact of loneliness and social isolation. Individual interventions to mitigate loneliness or isolation may enhance life satisfaction for both partners and not simply the intervention recipient.

3.
Artículo en Inglés | MEDLINE | ID: mdl-35128725

RESUMEN

BACKGROUND: Global initiatives that promote public health responses to dementia have resulted in numerous countries developing new national policies. Current policy guidelines in England, for example, recommend that people diagnosed with mild-to-moderate dementia receive information and psychosocial interventions to improve their ability to 'live well'. However, it remains unclear to what extent these recommendations are being achieved. METHODS: Self-reported information from 1537 people living with dementia and informant-reported information from 1277 carers of people living with dementia was used to quantify receipt of community-based dementia support services, including health and social care services provided by statutory or voluntary-sector organisations, in Britain from 2014 to 2016. Demographic factors associated with differences in receipt of support services were also investigated to identify particularly vulnerable groups of people living with dementia. RESULTS: Both self- and informant reports suggested that approximately 50% of people living with dementia received support services for dementia. Receipt of support services was lower among people living with dementia who are older, female, and have fewer educational qualifications. Receipt of support services also differed according to diagnosis and carer status, but was unrelated to marital status. CONCLUSIONS: Limited receipt of dementia support services among people living with dementia in Britain provides a baseline to assess the efficacy of current policy guidelines regarding provision of information and support. Targeted efforts to facilitate receipt of support services among the particularly vulnerable groups identified in the current study could improve the efficacy of dementia support services both in Britain and internationally, and should inform policy development.


Asunto(s)
Demencia , Cuidadores/psicología , Estudios de Cohortes , Demencia/psicología , Demencia/terapia , Inglaterra , Femenino , Humanos , Apoyo Social
4.
Ecol Lett ; 24(4): 751-760, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33616308

RESUMEN

Cognitive biases for encoding spatial information (orientation strategies) in relation to self (egocentric) or landmarks (allocentric) differ between species or populations according to the habitats they occupy. Whether biases in orientation strategy determine early habitat selection or if individuals adapt their biases following experience is unknown. We determined orientation strategies of pheasants, Phasianus colchicus, using a dual-strategy maze with an allocentric probe trial, before releasing them (n = 20) into a novel landscape, where we monitored their movement and habitat selection. In general, pheasants selected for woodland over non-woodland habitat, but allocentric-biased individuals exhibited weaker avoidance of non-woodland habitat, where we expected allocentric navigation to be more effective. Sex did not influence selection but was associated with speed and directional persistence in non-woodland habitat. Our results suggest that an individual's habitat selection is associated with inherent cognitive bias in early life, but it is not yet clear what advantages this may offer.


Asunto(s)
Navegación Espacial , Sesgo , Cognición , Ecosistema , Humanos , Aprendizaje por Laberinto
5.
Anim Cogn ; 23(1): 215-225, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31758353

RESUMEN

The ability to inhibit prepotent actions towards rewards that are made inaccessible by transparent barriers has been considered to reflect capacities for inhibitory control (IC). Typically, subjects initially reach directly, and incorrectly, for the reward. With experience, subjects may inhibit this action and instead detour around barriers to access the reward. However, assays of IC are often measured across multiple trials, with the location of the reward remaining constant. Consequently, other cognitive processes, such as response learning (acquisition of a motor routine), may confound accurate assays of IC. We measured baseline IC capacities in pheasant chicks, Phasianus colchicus, using a transparent cylinder task. Birds were then divided into two training treatments, where they learned to access a reward placed behind a transparent barrier, but experienced differential reinforcement of a particular motor response. In the stationary-barrier treatment, the location of the barrier remained constant across trials. We, therefore, reinforced a fixed motor response, such as always go left, which birds could learn to aid their performance. Conversely, we alternated the location of the barrier across trials for birds in the moving-barrier treatment and hence provided less reinforcement of their response learning. All birds then experienced a second presentation of the transparent cylinder task to assess whether differences in the training treatments influenced their subsequent capacities for IC. Birds in the stationary-barrier treatment showed a greater improvement in their subsequent IC performance after training compared to birds in the moving-barrier treatment. We, therefore, suggest that response learning aids IC performance on detour tasks. Consequently, non-target cognitive processes associated with different neural substrates appear to underlie performances on detour tasks, which may confound accurate assays of IC. Our findings question the construct validity of a commonly used paradigm that is widely considered to assess capacities for IC in humans and other animals.


Asunto(s)
Aprendizaje , Recompensa , Animales , Aves , Humanos
6.
Anim Cogn ; 23(1): 189-202, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31845017

RESUMEN

Inhibitory control (IC) is the ability to intentionally restrain initial, ineffective responses to a stimulus and instead exhibit an alternative behaviour that is not pre-potent but which effectively attains a reward. Individuals (both humans and non-human animals) differ in their IC, perhaps as a result of the different environmental conditions they have experienced. We experimentally manipulated environmental predictability, specifically how reliable information linking a cue to a reward was, over a very short time period and tested how this affected an individual's IC. We gave 119 pheasants (Phasianus colchicus) the opportunity to learn to associate a visual cue with a food reward in a binary choice task. We then perturbed this association for half the birds, whereas control birds continued to be rewarded when making the correct choice. We immediately measured all birds' on a detour IC task and again 3 days later. Perturbed birds immediately performed worse than control birds, making more unrewarded pecks at the apparatus than control birds, although this effect was less for individuals that had more accurately learned the initial association. The effect of the perturbation was not seen 3 days later, suggesting that individual IC performance is highly plastic and susceptible to recent changes in environmental predictability. Specifically, individuals may perform poorly in activities requiring IC immediately after information in their environment is perturbed, with the perturbation inducing emotional arousal. Our finding that recent environmental changes can affect IC performance, depending on how well an animal has learned about that environment, means that interpreting individual differences in IC must account for both prior experience and relevant individual learning abilities.


Asunto(s)
Galliformes , Aprendizaje , Animales , Individualidad , Recompensa
7.
J Anim Ecol ; 89(6): 1340-1349, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32118295

RESUMEN

Social environments influence important ecological processes and can determine how selection acts on traits. Cognitive abilities can shape these social environments and in turn, affect individuals' fitness. To understand how cognitive abilities evolve, we need to understand the complex interplay between an individual's cognitive abilities, the social environment that they inhabit and the fitness consequences of these relationships. We measured the associative learning ability of pheasant chicks, Phasianus colchicus, then released them into the wild where we quantified their social position by observing their associations at feeding stations and monitored the number of days survived. We observed disassortative mixing by learning performance at the population level, and poor learners had more associates than good learners. Learning was beneficial for survival when focal individuals had fewer than four associates, but survival probability across learning abilities equalized for individuals with more than four associates. While the mechanisms underlying these relationships remain to be determined, the patterns of association exhibited by pheasants at feeders can be predicted by individual variation in cognitive performances and we suspect these patterns are related to differences in information use. Critically, these resulting patterns of association have fitness consequences for individuals that cannot be explained directly by their cognitive ability, but which could mediate selection on cognition.


Asunto(s)
Cognición , Aprendizaje , Adulto , Animales , Inteligencia , Fenotipo
8.
Learn Behav ; 48(1): 84-95, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31916193

RESUMEN

The differential specialization of each side of the brain facilitates the parallel processing of information and has been documented in a wide range of animals. Animals that are more lateralized as indicated by consistent preferential limb use are commonly reported to exhibit superior cognitive ability as well as other behavioural advantages. We assayed the lateralization of 135 young pheasants (Phasianus colchicus), indicated by their footedness in a spontaneous stepping task, and related this measure to individual performance in either 3 assays of visual or spatial learning and memory. We found no evidence that pronounced footedness enhances cognitive ability in any of the tasks. We also found no evidence that an intermediate footedness relates to better cognitive performance. This lack of relationship is surprising because previous work revealed that pheasants have a slight population bias towards right footedness, and when released into the wild, individuals with higher degrees of footedness were more likely to die. One explanation for why extreme lateralization is constrained was that it led to poorer cognitive performance, or that optimal cognitive performance was associated with some intermediate level of lateralization. This stabilizing selection could explain the pattern of moderate lateralization that is seen in most non-human species that have been studied. However, we found no evidence in this study to support this explanation.


Asunto(s)
Galliformes , Navegación Espacial , Animales , Cognición , Color , Lateralidad Funcional
9.
Anim Cogn ; 22(6): 1105-1114, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31471781

RESUMEN

The ability to control impulsive actions is an important executive function that is central to the self-regulation of behaviours and, in humans, can have important implications for mental and physical health. One key factor that promotes individual differences in inhibitory control (IC) is the predictability of environmental information experienced during development (i.e. reliability of resources and social trust). However, environmental predictability can also influence motivational and other cognitive abilities, which may therefore confound interpretations of the mechanisms underlying IC. We investigated the role of environmental predictability, food motivation and cognition on IC. We reared pheasant chicks, Phasianus colchicus, under standardised conditions, in which birds experienced environments that differed in their spatial predictability. We systematically manipulated spatial predictability during their first 8 weeks of life, by either moving partitions daily to random locations (unpredictable environment) or leaving them in fixed locations (predictable environment). We assessed motivation by presenting pheasants with two different foraging tasks that measured their dietary breadth and persistence to acquire inaccessible food rewards, as well as recording their latencies to acquire a freely available baseline worm positioned adjacent to each test apparatus, their body condition (mass/tarsus3) and sex. We assessed cognitive performance by presenting each bird with an 80-trial binary colour discrimination task. IC was assessed using a transparent detour apparatus, which required subjects to inhibit prepotent attempts to directly acquire a visible reward through the barrier and instead detour around a barrier. We found greater capacities for IC in pheasants that were reared in spatially unpredictable environments compared to those reared in predictable environments. While IC was unrelated to individual differences in cognitive performance on the colour discrimination task or motivational measures, we found that environmental predictability had differential effects on sex. Males reared in an unpredictable environment, and all females regardless of their rearing environment, were less persistent than males reared in a predictable environment. Our findings, therefore, suggest that an individual's developmental experience can influence their performance on IC tasks.


Asunto(s)
Galliformes , Individualidad , Animales , Cognición , Femenino , Masculino , Motivación , Reproducibilidad de los Resultados
10.
Intelligence ; 74: 53-61, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31217648

RESUMEN

It remains unclear whether performance of non-human animals on cognitive test batteries can be explained by domain general cognitive processes, as is found in humans. The persistence of this dispute is likely to stem from a lack of clarity of the psychological or neural processes involved. One broadly accepted cognitive process, that may predict performance in a range of psychometric tasks, is associative learning. We therefore investigated intra-individual performances on tasks that incorporate processes of associative learning, by assessing the speed of acquisition and reversal learning in up to 187 pheasants (Phasianus colchicus) on four related binary colour discrimination tasks. We found a strong, positive significant bivariate relationship between an individual's acquisition and reversal learning performances on one cue set. Weak, positive significant bivariate relationships were also found between an individual's performance on pairs of reversal tasks and between the acquisition and reversal performances on different cue sets. A single factor, robust to parallel analysis, explained 36% of variation in performance across tasks. Inter-individual variation could not be explained by differential prior experience, age, sex or body condition. We propose that a single factor explanation, which we call 'a', summarises the covariance among scores obtained from these visual discrimination tasks, as they all assess capacities for associative learning. We argue that 'a' may represent an underlying cognitive ability exhibited by an individual, which manifests across a variety of tasks requiring associative processes.

11.
Proc Biol Sci ; 285(1875)2018 03 28.
Artículo en Inglés | MEDLINE | ID: mdl-29593115

RESUMEN

Transparent Cylinder and Barrier tasks are used to purportedly assess inhibitory control in a variety of animals. However, we suspect that performances on these detour tasks are influenced by non-cognitive traits, which may result in inaccurate assays of inhibitory control. We therefore reared pheasants under standardized conditions and presented each bird with two sets of similar tasks commonly used to measure inhibitory control. We recorded the number of times subjects incorrectly attempted to access a reward through transparent barriers, and their latencies to solve each task. Such measures are commonly used to infer the differential expression of inhibitory control. We found little evidence that their performances were consistent across the two different Putative Inhibitory Control Tasks (PICTs). Improvements in performance across trials showed that pheasants learned the affordances of each specific task. Critically, prior experience of transparent tasks, either Barrier or Cylinder, also improved subsequent inhibitory control performance on a novel task, suggesting that they also learned the general properties of transparent obstacles. Individual measures of persistence, assayed in a third task, were positively related to their frequency of incorrect attempts to solve the transparent inhibitory control tasks. Neophobia, Sex and Body Condition had no influence on individual performance. Contrary to previous studies of primates, pheasants with poor performance on PICTs had a wider dietary breadth assayed using a free-choice task. Our results demonstrate that in systems or taxa where prior experience and differences in development cannot be accounted for, individual differences in performance on commonly used detour-dependent PICTS may reveal more about an individual's prior experience of transparent objects, or their motivation to acquire food, than providing a reliable measure of their inhibitory control.


Asunto(s)
Cognición/fisiología , Exactitud de los Datos , Galliformes/fisiología , Inhibición Psicológica , Animales , Conducta Animal , Correlación de Datos , Individualidad , Aprendizaje/fisiología , Motivación , Recompensa
12.
Anim Cogn ; 20(6): 1035-1047, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28795236

RESUMEN

Inhibitory control enables subjects to quickly react to unexpectedly changing external demands. We assessed the ability of young (8 weeks old) pheasants Phasianus colchicus to exert inhibitory control in a novel response-inhibition task that required subjects to adjust their movement in space in pursuit of a reward across changing target locations. The difference in latencies between trials in which the target location did and did not change, the distance travelled towards the initially indicated location after a change occurred, and the change-signal reaction time provided a consistent measure that could be indicative of a pheasant's inhibitory control. Between individuals, there was a great variability in these measures; these differences were not correlated with motivation either to access the reward or participate in the test. However, individuals that were slower to reach rewards in trials when the target did not change exhibited evidence of stronger inhibitory control, as did males and small individuals. This novel test paradigm offers a potential assay of inhibitory control that utilises a natural feature of an animal's behavioural repertoire, likely common to a wide range of species, specifically their ability to rapidly alter their trajectory when reward locations switch.


Asunto(s)
Conducta Animal , Cognición/fisiología , Galliformes/fisiología , Animales , Femenino , Individualidad , Masculino , Motivación , Factores Sexuales
13.
Behav Brain Sci ; 40: e220, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-29342676

RESUMEN

Are the mechanisms underlying variations in the performance of animals on cognitive test batteries analogous to those of humans? Differences might result from procedural inconsistencies in test battery design, but also from differences in how animals and humans solve cognitive problems. We suggest differentiating associative-based (learning) from rule-based (knowing) tasks to further our understanding of cognitive evolution across species.


Asunto(s)
Cognición , Inteligencia , Animales , Humanos
14.
Anim Cogn ; 19(6): 1195-1203, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27639565

RESUMEN

Physical cognition has generally been assessed in tool-using species that possess a relatively large brain size, such as corvids and apes. Parrots, like corvids and apes, also have large relative brain sizes, yet although parrots rarely use tools in the wild, growing evidence suggests comparable performances on physical cognition tasks. It is, however, unclear whether success on such tasks is facilitated by previous experience and training procedures. We therefore investigated physical comprehension of object relationships in two non-tool-using species of captive neotropical parrots on a new means-end paradigm, the Trap-Gaps task, using unfamiliar materials and modified training procedures that precluded procedural cues. Red-shouldered macaws (Diopsittaca nobilis) and black-headed caiques (Pionites melanocephala) were presented with an initial task that required them to discriminate between pulling food trays through gaps while attending to the respective width of the gaps and size of the trays. Subjects were then presented with a novel, but functionally equivalent, transfer task. Six of eight birds solved the initial task through trial-and-error learning. Four of these six birds solved the transfer task, with one caique demonstrating spontaneous comprehension. These findings suggest that non-tool-using parrots may possess capacities for sophisticated physical cognition by generalising previously learned rules across novel problems.


Asunto(s)
Comprensión , Loros , Animales , Cognición , Señales (Psicología) , Passeriformes
15.
BMJ Surg Interv Health Technol ; 6(1): e000251, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38895600

RESUMEN

Objectives: Assess the effect of a modified muscle sparing posterior approach; SPAIRE (Save Piriformis and Internus, Repairing Externus), in hip hemiarthroplasty for displaced intracapsular fractures on postoperative mobility and function compared with a standard lateral approach. Design: Pragmatic, superiority, multicenter, parallel-group, randomized controlled trial (with internal pilot). Participants, ward staff, and research staff conducting postoperative assessments were blinded to allocation. A CTU allocated treatments centrally using computer-generated lists. Setting: Six hospitals in Southwest England, recruiting November 25, 2019-April 25, 2022. Participants: 244 adults (≥60 years) requiring hip hemiarthroplasty (122 allocated to each approach). 90 and 85 participants allocated to SPAIRE and lateral, respectively, had primary outcome data within the prespecified data collection window. Interventions: Surgery using SPAIRE or standard lateral approach. Follow-up 3 days and 120 days postoperation. Main outcome measure: Oxford Hip Score (OHS), via telephone at 120 days. Secondary outcomes: function and mobility (3 days), pain (3 days, 120 days), discharge destination, length of hospital stay, complications and mortality (within 120 days), quality of life and place of residence (120 days). Results: Participants' mean age was 84.6 years (SD 7.2); 168 (69%) were women. Primary outcome: little evidence of a difference in OHS at 120 days; adjusted mean difference (SPAIRE-lateral) -1.23 (95% CI -3.96 to 1.49, p=0.37). Secondary outcomes: indication of lower participant-reported pain at 3 days in SPAIRE arm; no differences between arms for remaining outcomes. Conclusions: Participants' mobility and function are similar in the short term (3 days) and longer term (120 days), whether receiving the SPAIRE or lateral approach. Neither approach confers benefit over the other in terms of length of hospital stay, return to prefracture residence, survival within 120 days, or quality of life at 120 days. Participants receiving SPAIRE approach may experience less pain in the early postoperative period. Modifying the posterior approach in hip hemiarthroplasty to the SPAIRE approach gives equivalent patient outcomes to the lateral approach within 120 days. Trial registration number: NCT04095611.

16.
Br J Gen Pract ; 74(741): e233-e241, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38499365

RESUMEN

BACKGROUND: Sleep disturbance is a prevalent condition among people living with dementia (PLwD) or mild cognitive impairment (MCI). Its assessment and management within primary care is complex because of the comorbidities, older age, and cognitive impairment typical of this patient group. AIM: To explore how primary care clinicians assess, understand, and manage sleep disturbance for PLwD or MCI; if and why such initiatives work; and how people and their carers experience sleep disturbance and its treatment. DESIGN AND SETTING: A realist review of existing literature conducted in 2022. METHOD: Six bibliographic databases were searched. Context-mechanism-outcome configurations (CMOCs) were developed and refined. RESULTS: In total, 60 records were included from 1869 retrieved hits and 19 CMOCs were developed. Low awareness of and confidence in the treatment of sleep disturbance among primary care clinicians and patients, combined with time and resource constraints, meant that identifying sleep disturbance was difficult and not prioritised. Medication was perceived by clinicians and patients as the primary management tool, resulting in inappropriate or long-term prescription. Rigid nursing routines in care homes were reportedly not conducive to good-quality sleep. CONCLUSION: In primary care, sleep disturbance among PLwD or MCI is not adequately addressed. Over-reliance on medication, underutilisation of non-pharmacological strategies, and inflexible care home routines were reported as a result of low confidence in sleep management and resource constraints. This does not constitute effective and person-centred care. Future work should consider ways to tailor the assessment and management of sleep disturbance to the needs of individuals and their informal carers without overstretching services.


Asunto(s)
Disfunción Cognitiva , Demencia , Medicina General , Trastornos del Sueño-Vigilia , Humanos , Demencia/complicaciones , Disfunción Cognitiva/etiología , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/terapia , Atención Primaria de Salud , Cuidadores/psicología
17.
Nat Ecol Evol ; 7(3): 461-471, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36690732

RESUMEN

Most animals confine their activities to a discrete home range, long assumed to reflect the fitness benefits of obtaining spatial knowledge about the landscape. However, few empirical studies have linked spatial memory to home range development or determined how selection operates on spatial memory via the latter's role in mediating space use. We assayed the cognitive ability of juvenile pheasants (Phasianus colchicus) reared under identical conditions before releasing them into the wild. Then, we used high-throughput tracking to record their movements as they developed their home ranges, and determined the location, timing and cause of mortality events. Individuals with greater spatial reference memory developed larger home ranges. Mortality risk from predators was highest at the periphery of an individual's home range in areas where they had less experience and opportunity to obtain spatial information. Predation risk was lower in individuals with greater spatial memory and larger core home ranges, suggesting selection may operate on spatial memory by increasing the ability to learn about predation risk across the landscape. Our results reveal that spatial memory, determined from abstract cognitive assays, shapes home range development and variation, and suggests predation risk selects for spatial memory via experience-dependent spatial variation in mortality.


Asunto(s)
Galliformes , Fenómenos de Retorno al Lugar Habitual , Animales , Memoria Espacial , Conducta Predatoria
18.
Trials ; 23(1): 924, 2022 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-36335403

RESUMEN

BACKGROUND: The HemiSPAIRE trial is being conducted to determine whether a modified muscle sparing technique (SPAIRE-"Save Piriformis and Internus, Repairing Externus") in hip hemiarthroplasty brings clinical benefits compared to the standard lateral technique in adults aged 60 years or older, with a displaced intracapsular hip fracture. This article describes the detailed statistical analysis plan for the trial.  METHODS AND DESIGN: HemiSPAIRE is a definitive, pragmatic, superiority, multicentre, randomised controlled trial (with internal pilot) with two parallel groups. Participants, ward staff and all research staff involved in post-operative assessments are blinded to allocation. This article describes in detail (1) the primary and secondary outcomes; (2) the statistical analysis principles, including a survivor average causal effect (SACE) method chosen specifically to address the issue of potential bias from differential survival between trial arms, which was seen from data review by the Trial Steering Committee, the participants that will be included in each analysis, the covariates that will be included in each analysis, and how the results will be presented; (3) planned main analysis of the primary outcome; (4) planned analyses of the secondary outcomes; and (5) planned additional analyses of the primary and secondary outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT04095611. Registered on 19 September 2019.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Hemiartroplastia , Fracturas de Cadera , Adulto , Humanos , Hemiartroplastia/efectos adversos , Hemiartroplastia/métodos , Fracturas de Cadera/cirugía , Artroplastia de Reemplazo de Cadera/métodos , Cadera/cirugía , Músculos/cirugía , Resultado del Tratamiento
19.
BMJ Open ; 12(11): e067424, 2022 11 18.
Artículo en Inglés | MEDLINE | ID: mdl-36400725

RESUMEN

INTRODUCTION: The increasingly ageing population is associated with greater numbers of people living with dementia (PLwD) and mild cognitive impairment (MCI). There are an estimated 55 million PLwD and approximately 6% of people over 60 years of age are living with MCI, with the figure rising to 25% for those aged between 80 and 84 years. Sleep disturbances are common for this population, but there is currently no standardised approach within UK primary care to manage this. Coined as a 'wicked design problem', sleep disturbances in this population are complex, with interventions supporting best management in context. METHODS AND ANALYSIS: The aim of this realist review is to deepen our understanding of what is considered 'sleep disturbance' in PLwD or MCI within primary care. Specifically, we endeavour to better understand how sleep disturbance is assessed, diagnosed and managed. To co-produce this protocol and review, we have recruited a stakeholder group comprising individuals with lived experience of dementia or MCI, primary healthcare staff and sleep experts. This review will be conducted in line with Pawson's five stages including the development of our initial programme theory, literature searches and the refinement of theory. The Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and reporting standards will also be followed. The realist review will be an iterative process and our initial realist programme theory will be tested and refined in response to our data searches and stakeholder discussions. ETHICS AND DISSEMINATION: Ethical approval is not required for this review. We will follow the RAMESES standards to ensure we produce a complete and transparent report. Our final programme theory will help us to devise a tailored sleep management tool for primary healthcare professionals, PLwD and their carers. Our dissemination strategy will include lay summaries via email and our research website, peer-reviewed publications and social media posts. PROSPERO REGISTRATION NUMBER: CRD42022304679.


Asunto(s)
Disfunción Cognitiva , Demencia , Humanos , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Envejecimiento , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/terapia , Disfunción Cognitiva/complicaciones , Demencia/complicaciones , Demencia/diagnóstico , Atención Primaria de Salud , Sueño , Literatura de Revisión como Asunto
20.
R Soc Open Sci ; 8(3): 201758, 2021 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-33959338

RESUMEN

Memories about the spatial environment, such as the locations of foraging patches, are expected to affect how individuals move around the landscape. However, individuals differ in the ability to remember spatial locations (spatial cognitive ability) and evidence is growing that these inter-individual differences influence a range of fitness proxies. Yet empirical evaluations directly linking inter-individual variation in spatial cognitive ability and the development and structure of movement paths are lacking. We assessed the performance of young pheasants (Phasianus colchicus) on a spatial cognition task before releasing them into a novel, rural landscape and tracking their movements. We quantified changes in the straightness and speed of their transitory paths over one month. Birds with better performances on the task initially made slower transitory paths than poor performers but by the end of the month, there was no difference in speed. In general, birds increased the straightness of their path over time, indicating improved efficiency independent of speed, but this was not related to performance on the cognitive task. We suggest that initial slow movements may facilitate more detailed information gathering by better performers and indicates a potential link between an individual's spatial cognitive ability and their movement behaviour.

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