Large Home Research Articles

Exploring communication challenges in dementia care: Insights from home healthcare nurses

ObjectivesCare for people living with dementia predominantly takes place at home and is often characterized by multiple hospitalizations throughout the lengthy disease trajectory. Care transitions from the hospital often involve home health care. The purpose of this study was to explore communication challenges experienced by home health nurses to inform communication training needs for home-based dementia care. MethodsSeven audio-recorded focus group discussions were held with home health nurses (n = 31) from a large home care agency serving rural and urban counties. Focus group transcripts were thematically analyzed. ResultsWe identified the following themes highlighting communication challenges for home health nurses: addressing potential risk for harm or injury, patient vulnerability, care partner needs, shifting decision-making to surrogate, and discrepancy in home health goals and family needs. These themes identified specific care transition conversation topics and communication content imperative for dementia-specific staff training. ConclusionsTopics for communication skills training to improve person-centered dementia care were identified. These findings inform the future development of a home health staff communication curriculum for dementia care. Advanced communication skills are necessary to ensure these conversations take place and are engaged with sensitivity. Practice implicationsOur study informs the development of communication training on key communication topics in nurse-delivered and home healthcare interventions aimed at improving dementia care.

Parental attitudes and perceptions towards the recruitment of children to clinical trials: a cross-sectional survey.

Clinical trials (CTs) in children are critical for understanding and treating childhood diseases. However, there trials require prior permission from parents. We evaluated parental attitudes and perceptions regarding the recruitment of their children in CTs. We used a cross-sectional survey questionnaire targeting parents of children admitted to the neonatal and pediatric departments in two tertiary hospitals in Qatar. The survey was administered by investigators and was composed of two domains to assess the knowledge and attitude of parents regarding children's enrollment in CTs, in addition to the participant's demographics domain. Of the 167 questionnaires offered to parents, we received a total of 138 responses, resulting in a response rate of 82.6%, with the majority being women (72%). Many parents (75%) expressed willingness to enroll their children in CTs. However, 66% opposed new experimental treatments for their child, while 41% agreed to new treatments if they had previously been used in the medical field. Logistic regression analysis revealed key predictors influencing parents' decisions to include their children in CTs, including having a newborn (aOR = 17.651, p < 0.001), families with five or more members (aOR = 3.293, p = 0.012), collecting blood samples (aOR = 8.602, p = 0.003), performing additional tests on collected samples (aOR = 4.115, p = 0.046), belief in helping others (aOR = 8.744, p = 0.002), and the option of home therapy (aOR = 7.090, p = 0.004). Many parents are open to enrolling their children in CTs, particularly when treatments have been previously used. Factors like having a newborn, large family size, blood collection, additional tests, and home therapy influence their decisions. Clear communication can enhance recruitment in pediatric trials.

A chromosome-level genome assembly of the mountain lion, Puma concolor.

Mountain lions, Puma concolor, are widespread and adaptable carnivores. However, due to their large home ranges and long distance dispersals, they are strongly impacted by habitat fragmentation, which results in small and isolated populations. Genomic analyses play an important role in understanding and predicting the impacts of increased isolation of populations, such as decreased genetic diversity and increased levels of inbreeding. Here we report a high-quality, chromosome-level reference genome of P. concolor that was generated as part of the California Conservation Genomics Project. The primary assembly has a total length of 2.5 Gb contained in 258 scaffolds, a contig N50 of 42.3Mb, a scaffold N50 of 149.8Mb, and a BUSCO completeness score of 95%. This P. concolor genome assembly will provide an important resource for genomic analyses that aid decision makers in managing the species in fragmented landscapes.

Data Mining Approach for Evil Twin Attack Identification in Wi-Fi Networks

Recent cyber security solutions for wireless networks during internet open access have become critically important for personal data security. The newest WPA3 network security protocol has been used to maximize this protection; however, attackers can use an Evil Twin attack to replace a legitimate access point. The article is devoted to solving the problem of intrusion detection at the OSI model’s physical layers. To solve this, a hardware–software complex has been developed to collect information about the signal strength from Wi-Fi access points using wireless sensor networks. The collected data were supplemented with a generative algorithm considering all possible combinations of signal strength. The k-nearest neighbor model was trained on the obtained data to distinguish the signal strength of legitimate from illegitimate access points. To verify the authenticity of the data, an Evil Twin attack was physically simulated, and a machine learning model analyzed the data from the sensors. As a result, the Evil Twin attack was successfully identified based on the signal strength in the radio spectrum. The proposed model can be used in open access points as well as in large corporate and home Wi-Fi networks to detect intrusions aimed at substituting devices in the radio spectrum where IEEE 802.11 networking equipment operates.

Older adults’ decisions regarding mobility to age in place in medium- and high-rise multi-storey residential buildings in urban settings: A case study of South East Queensland, Australia

Population ageing and urbanisation requires a more thorough understanding and monitoring of older adult residential mobility trends. Many older adults move to urban areas and previous studies have been carried out on ageing in place in traditional low-rise residential buildings. However, there is little in the literature about the important push and pull factors influencing older adult moves to medium- and high-rise multi-storey residential buildings in urban areas as they age. This case study research considered the housing migration model of push and pull factors used in elderly residential mobility and investigated the older adults' decision-making regarding mobility to age in place in medium- and high-rise multi-storey residential buildings in South East Queensland, Australia. The study revealed how the older adults expressed a desire to age in place in multi-storey residential buildings in urban areas and identified it as an important element of quality of life. Many older adults chose to move house to high density urban areas from low density urban areas between the ages of 65 and 84. The ‘pull’ factor to significantly influence the decisions of movers was a low maintenance property and lifestyle change from a large suburban home whereas the ‘push’ factor was upkeep difficulties of the house related to old age. This study makes empirical contributions to knowledge in ageing residential mobility trends in urban areas and concludes by providing policy recommendations for developing more effective housing, public spaces, transportation, and community activities and services for older adults, including highlighting a number of recommendations for future research.

Fully protected marine areas linked to reduced home ranges of fishes

AbstractHome range size is a fundamental trait that can affect the probability of fish being harvested and, at the same time, may be affected by fishing. The relationship between home range size and fishing will impact the effectiveness of fully protected areas (FPAs), as it will influence the number of fish moving into fished areas, affecting both spillover and edge effects. One hypothesis is that individuals within FPAs will present reduced home range size relative to individuals in fished areas. This pattern can be driven by demographic selection (e.g. fishing of individuals with large home ranges leaving the FPAs), improved habitat requiring less foraging movements, or behavioural changes associated with reduced fishing threats. To test the relationship between home range size and protection, we compiled 1143 individual‐level home range sizes based on acoustic tracking, covering 17 species from 11 FPAs in 7 countries, with information on distance from FPA borders. A dichotomic analysis (in/out of FPAs) did not support a significant change in the home range size between FPAs and fished areas. However, continuous analysis across the FPA borders demonstrated reduced home range size within the FPAs. We did not find an effect of FPA age or size on this pattern. While we cannot pinpoint the underlying mechanism for the pattern revealed, we suggest behavioural changes as the main driver for reduced home range within FPAs. This mechanism will lead to more resident populations within FPAs, reducing fishing mortality within FPAs yet limiting spillover benefits to adjacent fisheries.

Factors Associated with Advance Care Planning Engagement Among Community‐Dwelling Older Adults: A Cross‐Sectional Study

ABSTRACTAimTo explore the associations between depression, anxiety, decisional conflict and advance care planning engagement and the potential mediating role of decisional conflict in the associations between depression, anxiety and advance care planning among community‐dwelling older adults.DesignA cross‐sectional study was conducted with 262 community‐dwelling older Australians across metropolitan, regional and rural communities between August and October 2022.MethodsValidated self‐reported questions were used to collect data on anxiety, depression (Hospital Anxiety and Depression Scale), decisional conflict (Decisional Conflict Scale), advance care planning engagement (Advance Care Planning Engagement Survey) and covariates (demographic characteristics, health literacy [Health Literacy Screening Questions]), overall health status (Short form 36). Data analysis included descriptive statistics, bivariate association analysis, general linear modelling and path analysis.ResultsAnxiety and decisional conflict were directly associated with advance care planning engagement even after controlling for potential effects of demographic characteristics, health literacy and overall health status. The model, including age, gender, country of birth, language spoken at home, education, overall health status, anxiety, depression, decisional conflict and interaction between anxiety and decisional conflict, explained 24.3% of the variance in their advance care planning engagement. Decisional conflict mediated the association between anxiety and advance care planning engagement.ConclusionIncreased anxiety and decisional conflict were associated with reduced advance care planning engagement directly, even among community‐dwelling older adults with higher levels of education and health literacy. Increased anxiety was associated with reduced advance care planning engagement indirectly via increased decisional conflict. Healthcare professionals should assess community‐dwelling older adults' anxiety and implement interventions to manage their anxiety and decisional conflict, as these may facilitate their engagement in advance care planning.ImpactUnderstanding factors associated with advance care planning engagement among community‐dwelling older adults may inform strategies facilitating their future engagement in advance care planning. Findings from this study may be used as evidence for future implementation to facilitate the engagement of community‐dwelling older adults in advance care planning.Reporting MethodThe STROBE statement checklist was used as a guide to writing the manuscript.Patient or Public ContributionThe study was advertised publicly through social media (e.g. Twitter and Facebook) and newsletters (e.g. Advance Care Planning Australia, Centre for Volunteering, Palliative Care Australia and a large home care service provider with approximately 7000 older clients receiving support or services) to recruit participants. People aged 65 years and older living independently in the Australian community who could communicate in English were invited to participate and answer the questionnaire.

Habitat suitability and protected area coverage for an expanding cougar Puma concolor population in Canada.

Successful conservation of expanding large carnivore populations and management of human-wildlife conflict to promote coexistence requires sufficient spatiotemporal knowledge to inform appropriate action. In Canada, cougars (Puma concolor) are expanding their range eastwards and little research is available for use in decision making by land managers and conservation planners. To inform proactive management regarding expanding populations of cougars in Canada, we utilized open-source cougar presence and land-cover data in a maximum entropy habitat suitability model to determine potentially suitable habitat for cougars across the country. We then used a gap analysis to determine the effectiveness of existing formal protected areas to protect potential cougar habitat. Suitable habitat exists for range-expanding cougars dispersing eastwards through the central and eastern provinces to the Atlantic coast. While the habitat is highly fragmented, the highest suitability occurs in areas of medium road density, indicating that the potential for new human-cougar conflict will likely involve residents of exurban and rural areas. Protected areas offered 16% coverage of suitable habitat, although most protected areas that overlap predicted cougar habitat are not large enough to effectively conserve the large home range requirements of cougars. Synthesis and Applications: High fragmentation of suitable habitat and the potential for human-wildlife conflict requires proactive management to ensure appropriately sized and connected areas are maintained for the establishment of expanding cougar populations. Many of the management actions intended to aid in the conservation of cougars and their habitat can also serve to mitigate potential human-cougar conflict arising as a consequence of an expanding population, such as highway wildlife crossing structures and formal habitat protection.

Evaluating Thermal Infrared Drone Flight Parameters on Spider Monkey Detection in Tropical Forests.

Geoffroy's spider monkeys, an endangered, fast-moving arboreal primate species with a large home range and a high degree of fission-fusion dynamics, are challenging to survey in their natural habitats. Our objective was to evaluate how different flight parameters affect the detectability of spider monkeys in videos recorded by a drone equipped with a thermal infrared camera and examine the level of agreement between coders. We used generalized linear mixed models to evaluate the impact of flight speed (2, 4, 6 m/s), flight height (40, 50 m above ground level), and camera angle (-45°, -90°) on spider monkey counts in a closed-canopy forest in the Yucatan Peninsula, Mexico. Our results indicate that none of the three flight parameters affected the number of detected spider monkeys. Agreement between coders was "substantial" (Fleiss' kappa coefficient = 0.61-0.80) in most cases for high thermal-contrast zones. Our study contributes to the development of standardized flight protocols, which are essential to obtain accurate data on the presence and abundance of wild populations. Based on our results, we recommend performing drone surveys for spider monkeys and other medium-sized arboreal mammals with a small commercial drone at a 4 m/s speed, 15 m above canopy height, and with a -90° camera angle. However, these recommendations may vary depending on the size and noise level produced by the drone model.

Local resource availability drives habitat use by a threatened avian granivore in savanna woodlands.

Conserving threatened species relies on an understanding of their habitat requirements. This is especially relevant for granivorous birds, whose habitat use and movement patterns are intricately linked to the spatial and temporal availability of resources such as food and water. In this study, we investigated the habitat use, home range and daily activity patterns of the Endangered Southern Black-throated Finch (SBTF; Poephila cincta cincta) within a 75,000 ha savanna woodland study area in northeastern Australia. This semi-arid region is one of the key remaining strongholds for the species and is characterised by substantially different habitat and climatic conditions than areas where previous research on this species has been undertaken. We radio tracked 142 SBTF using both manual tracking and an array of 27 automated radio towers, which revealed a strong preference for eucalypt-dominated grassy woodland communities. The preference for these habitats also increased with decreasing distance to permanent water. While SBTF occupied large home ranges, individual SBTF were largely sedentary during the radio tracking period (21.8, range = 0.83-120 days), with few landscape-scale movements of more than 4.5 km. Daily foraging activity of SBTF exhibited bimodal peaks in the early morning and late afternoon, while other activities were greatest from the late morning to the early afternoon. Compared to other estrildid finches, our research suggests that SBTF track resources at a local scale across a large home range. We postulate that in times of resource scarcity SBTF may use dietary diversification, instead of landscape or regional-scale nomadic movements, to meet their resource needs. The species' movement patterns underscore the importance of local scale habitat management to facilitate resource availability throughout the year. Furthermore, our research helps target monitoring designs for granivorous birds that focus on the species' diurnal activity patterns.

Cardamom (Amomum tsaoko) agroforest is important habitat for skywalker hoolock gibbon (Hoolock tianxing) in Mt. Gaoligong, Yunnan, China

Understory plantation of cardamom (genus Amomum) is an ancient and widespread agroforestry practice in the eastern Himalayas and Southeast Asia, an area that supports high regional biodiversity. Cardamom provides an important cash income to rural people, and governments encourage cardamom cultivation as a replacement for slash-and-burn agriculture to alleviate poverty, aligning with the principles of the Globally Important Agricultural Heritage Systems (GIAHS) program initiated by the FAO. This program recognizes and supports traditional agricultural practices that contributes to biodiversity conservation and sustainable development. In this context, cardamom agroforestry not only supports local economies but also provides crucial habitat for animals, including the newly described skywalker hoolock gibbon (Hoolock tianxing). Nearly half of the remnant population of the skywalker hoolock gibbon lives in cardamom agroforest. In order to evaluate if gibbons could survive in cardamom agroforest for a relatively long term, we compared foraging behavior of gibbons over a year living in cardamom agroforests (group NA) and well-preserved forests (group BB) in Mt. Gaoligong, Yunnan, China. In response to habitat degradation caused by cardamom plantation, group NA increased feeding time and spent more time feeding on leaves. Notably, they consumed nuts of Castanopsis hystrix which is an unusual food type for gibbons. On the contrary, members of group BB rarely ate nuts though Castanopsis hystrix is abundant within its home range. However, group NA did not occupy a large home range, or travel longer in time or distance than group BB. We also monitored female reproduction of five groups for 5–13 years. Two adult females living in agroforests successfully reared two or three offspring with an inter-birth interval of five years. In addition, we surveyed group size of 16 groups (9 in agroforest vs. 7 in well preserved forests) from 2017 to 2023, and we found no significant difference in group size between habitats. Our results suggested that cardamom agroforest can sustain skywalker hoolock gibbons provided it is not too fragmented and hunting is prohibited.

Western spotted skunk spatial ecology in the temperate rainforests of the Pacific Northwest

AbstractA major threat to small mammalian carnivore populations is human‐induced land use change, but conservation and management are inhibited by limited knowledge about their ecology and natural history. To fill a key knowledge gap of the western spotted skunk (Spilogale gracilis), we investigated their spatial ecology at the landscape and home range scale in the temperate rainforests of the Oregon Cascades during 2017–2019. For the landscape scale analysis, we used detections of western spotted skunks at 112 baited camera traps and fitted a dynamic occupancy model to investigate spatial distribution and drivers of inter‐seasonal and inter‐annual changes in occupancy. Concurrently, we radio‐collared 25 spotted skunks (9 female, 16 male) and collected 1583 relocations. Using continuous‐time movement models, we estimated large home range sizes for both male and female spotted skunks, relative to their body mass, and highly overlapping home ranges that indicated a lack of territoriality. Using these home ranges, we fitted a resource selection function using environmental covariates that we assigned to various hypotheses such as resources, predator avoidance, thermal tolerance, and disturbance. Overall, western spotted skunks were widely distributed across our study area (seasonal occupancy up to 63.7 ± 5.3%) and highly detectable (weekly detection probability = 41.2%). At both spatial scales, spotted skunks selected wetter areas and local valleys, which we attributed to areas with more food resources. At the home range scale, spotted skunks selected locations with lower predation risk and areas surrounded by more previously logged forests. In this montane environment, inter‐seasonal contractions in the spatial distributions of spotted skunks were strongly driven by their response to cold temperature and accumulated snow. This was especially evident when seasonal occupancy declined significantly following a severe heavy snow event in February 2019. Given that there is little information available on the natural history of the western spotted skunk, these results provide essential information about their ecology to focus future monitoring efforts and may help identify potential threats (e.g., forest management, severe snow events, or wildfires) to this species.

The Holocene to modern Fraser River Delta, Canada: geological history, processes, deposits, natural hazards, and coastal management

The Fraser River Delta (FRD) is a large sedimentary system and home to Metro Vancouver, situated within the unceded territories of several First Nations. This review provides an overview of the geological evolution of the FRD, connecting hydrodynamic processes with sedimentary deposits across its diverse environments, from the river to the delta slope. The study emphasizes the implications of sedimentation and delta evolution for natural hazards and coastal/delta management, pinpointing knowledge gaps. Comprising four main zones—river, delta plain, tidal flats, and delta slope—the FRD is subject to several natural hazards, including subsidence, flooding, earthquakes, liquefaction, and tsunamis. The delta plain, bordering the Fraser River's distributary channels, hosts tidal marshes and flats, including both active and abandoned areas. Active tidal flats like Roberts Bank and Sturgeon Bank receive sediment directly from the Fraser River, while abandoned tidal flats, like those at Boundary Bay and Mud Bay, no longer receive sediment. The tidal flats transition into the delta slope, characterized by sand in the south and mud in the north of the Main Channel. The FRD's susceptibility to hazards necessitates protective measures, with approximately 250 km of dykes shielding the delta plain from river floods and storm surges. Subsidence amplifies the impact of rising sea levels. Earthquakes in the region can induce tsunamis, submarine slope failures, and liquefaction of delta sediments, emphasizing the importance of incorporating sedimentation patterns and delta evolution into management strategies for sustainable urban development, habitat restoration, and coastal defence initiatives.

Did large foraging migrations favor the enormous body size of giant sauropods? The case of Turiasaurus

We propose that the huge sizes attained by many sauropod dinosaurs can be explained in the context of a climate characterized by pronounced seasonal changes. Under these conditions, the large herbivores would have become migratory, forced to move great distances during the drier times of year, in which case large body size becomes an adaptive advantage, since large home ranges and the ability to travel great distances increase with size. In this way, the need for a large foraging radius is a potent source of selection for larger size, and the capacity for sauropods to migrate and explore new territory was significantly higher than in extant herbivores. Examples discussed are Turiasaurus riodevensis and Camarasaurus lentus; some of their anatomical structures, such as vertebral neural extensions and crests associated with nasal cavities, can also be explained under this scenario, as adaptations to drought conditions.

Koala density, habitat, conservation, and response to logging in eucalyptus forest; a review and critical evaluation of call monitoring

ABSTRACT This study is the second in a series that examines the habitat requirements and response to logging of koalas (Phascolarctos cinereus) inhabiting tall eucalypt forests of north-east NSW. It presents the findings of koala population and habitat monitoring surveys in Pine Creek State Forest and Bongil Bongil National Park using a combination of call-counting and direct observation (spotlighting). The 6400 ha study area was mapped into 6 zones of increasing koala habitat quality by ground survey of forest structure and floristics on a 200 m grid. The accuracy of habitat definition and mapping was tested by stratified transect counts of koala calls and sightings over two consecutive years (1997–98). Average koala density increased steeply and significantly, from 0.02 – 0.20 koalas/hectare, with increasing mapped habitat quality based on increasing forest age, structural complexity, local food tree species diversity, history of prior koala occurrence and decreased past logging intensity. This relationship was driven primarily by breeding females, with the number of male koala calls weakly or uncorrelated with koala sightings and mapped habitat quality. Male koalas were more widely and uniformly distributed than females, including areas of low quality, plantation, and intensively logged forest. This finding explains the discrepancy between our results and those of other recent studies which concluded that koalas are tolerant of intensive logging based on modelling of calling male koalas and reliance on an untested assumption that male calling is indicative of female breeding success. Koala density in a subset of the highest quality habitat was relatively stable at 0.28 koalas/ha (3 hectares/koala) over the long term (1997–98 and 2012–2023). Key characteristics of the forest koala population, including low stable density, large home ranges, preference for high food tree diversity and locally unique food trees (including Allocasuarina torulosa and Syncarpia glomulifera), are not adequately explained by existing koala habitat models. We present a new paradigm to explain regional variation in koala distribution, habitat and foraging preferences based on variations in foliage chemistry (toxicity and nutritional value) determined by the duration and stability of local plant-koala interactions in response to past fire, hunting, predation and logging disturbance history. We hypothesize that koala density in stable forest populations is regulated at low levels by a combination of selected and induced increases in leaf toxicity and decreases in leaf nutrition that limit koala browsing to benign levels of about 1-2% of annual leaf production. Large home ranges, complex mature forest structure, high food tree diversity and a specialized or diverse gut microbiome may be essential to allow females to rotate and change food trees frequently to minimize induced toxicity and select individual leaves with sufficient nutrients to support breeding and lactation with minimal risk of predation. High density koala populations (&amp;gt; 0.6/ha) occur primarily in areas where koalas have been introduced or re-introduced to planted habitats and natural areas where aboriginal hunters and dingoes were historically present but are now absent, and where food trees have not been selected for resistance to koala browsing pressure.

Advancing Health Care Equity: A Memory Care Unit in a Large New York City Public Nursing Home

Advancing Health Care Equity: A Memory Care Unit in a Large New York City Public Nursing Home

Human-brown bear conflicts in Türkiye are driven by increased human presence around protected areas

Human-wildlife conflict has become a major challenge to conservation efforts around the world. Brown bears (Ursus arctos), which globally suffer from reduced habitat suitability and quality, frequently conflict with humans. These animals need large home ranges to fulfil their habitat requirements. When space and food are restricted, brown bears frequently shift towards human-dominated landscapes that offer reliable food sources. Türkiye, a country with predominantly human-dominated landscapes, experiences frequent human-brown bear conflicts (HBCs). However, there has been no formal analysis of the nature and scope of these conflicts at the country level. Using HBC data from 2017 to 2022, we analyzed the spatial and temporal dynamics of HBC events in Türkiye , constructing a risk map based on anthropogenic variables and geographic profiling to identify the driving forces. HBC events did not show any annual or seasonal trends but displayed considerable variation across biogeographic regions, with the highest incidence concentrated along the Black Sea coast and in Eastern Anatolia. Sixty percent of all conflicts were due to bear foraging behavior in or near human settlements while 12 % were the result of human activity in forests, with 57% of all conflict events resulting in direct injury to either humans or bears. Our analyses showed proximity to villages, protected areas, farmland, and the human footprint to be pivotal factors influencing conflict risk. Approximately 21% of the country's territory is susceptible to human-bear conflicts, with a substantial portion (43%) of these risks manifesting within a 10-km radius around protected areas. In conclusion, our findings suggest that the high occurrence of HBCs in Türkiye primarily stems from the limited availability of natural habitats and resources for brown bears, compounded by increased human encroachment in and around core bear habitats.

Natural Language Processing to Identify Home Health Care Patients at Risk for Becoming Incapacitated With No Evident Advance Directives or Surrogates

ObjectivesHome health care patients who are at risk for becoming Incapacitated with No Evident Advance Directives or Surrogates (INEADS) may benefit from timely intervention to assist them with advance care planning. This study aimed to develop natural language processing algorithms for identifying home care patients who do not have advance directives, family members, or close social contacts who can serve as surrogate decision-makers in the event that they lose decisional capacity. DesignCross-sectional study of electronic health records. Setting and ParticipantsPatients receiving post-acute care discharge services from a large home health agency in New York City in 2019 (n = 45,390 enrollment episodes). MethodsWe developed a natural language processing algorithm for identifying information documented in free-text clinical notes (n = 1,429,030 notes) related to 4 categories: evidence of close relationships, evidence of advance directives, evidence suggesting lack of close relationships, and evidence suggesting lack of advance directives. We validated the algorithm against Gold Standard clinician review for 50 patients (n = 314 notes) to calculate precision, recall, and F-score. ResultsAlgorithm performance for identifying text related to the 4 categories was excellent (average F-score = 0.91), with the best results for “evidence of close relationships” (F-score = 0.99) and the worst results for “evidence of advance directives” (F-score = 0.86). The algorithm identified 22% of all clinical notes (313,290 of 1,429,030) as having text related to 1 or more categories. More than 98% of enrollment episodes (48,164 of 49,141) included at least 1 clinical note containing text related to 1 or more categories. Conclusions and ImplicationsThis study establishes the feasibility of creating an automated screening algorithm to aid home health care agencies with identifying patients at risk of becoming INEADS. This screening algorithm can be applied as part of a multipronged approach to facilitate clinician support for advance care planning with patients at risk of becoming INEADS.

Review and meta-analysis of correlates of home range size in bats

Abstract Home range is an ecological concept that affects many aspects of the life of vertebrates and hence understanding how it varies between species is crucial. Mammalian home range size has been linked to body size and diet, but these studies were based predominantly on terrestrial species and most specifically excluded bats. As the only group of flying mammals, bats experience distinctly different constraints on movement, and hence home range. However, despite their diversity, relatively little is known about the home ranges of bats, and this is the first global review assessing correlates of their home range size. Our hypothesis is that home range will be impacted by different ecological conditions experienced by the bats and by the biological traits of the bats themselves. We performed a meta-analysis based on published data for 81 bat species to identify variables that contribute most to home range size. Sex, wing loading, functional group, colony size, dietary class, distance from the equator (latitudinal region), habitat type, and the interaction between habitat type and latitudinal region were all important explanatory variables. Wing loading was positively correlated with home range size—while females, open-air foragers, large colony sizes, and bats in temperate regions consistently had large home ranges. Understanding the correlates of home range has important implications, for example, for bat conservation and for assessing the risk of spillover of zoonotic pathogens from bats to humans and livestock.

Parasite infestation patterns differ between ticks and chigger mites on two rodent host species in Taiwan.

Parasites are typically concentrated on a few host individuals, and identifying the mechanisms underlying aggregated distribution can facilitate a more targeted control of parasites. We investigated the infestation patterns of hard ticks and chigger mites on two rodent species, the striped field mouse, Apodemus agrarius, and the lesser ricefield rat, Rattus losea, in Taiwan. We also explored abiotic and biotic factors that were important in explaining variation in the abundance of ticks and chiggers on rodent hosts. Ticks were more aggregated than chiggers on both rodent species. Factors important for the variation in parasitic loads, especially biotic factors, largely differed between ticks and chiggers. Variation partitioning analyses revealed that a larger proportion of variation in chiggers than in ticks can be explained, especially by abiotic factors. If, as proposed, the higher number of parasites in males is due to a larger range area or immunity being suppressed by testosterone, when A. agrarius males host more ticks, they are expected to also host more chiggers, given that chiggers adopt a similar host finding approach to that of ticks. Instead, the similar abundance of chiggers in male and female A. agrarius implies that a large home range or suppressed immunity does not predispose males to inevitably host more parasites. More variations were explained by abiotic than biotic factors, suggesting that controlling practices are more likely to be successful by focusing on factors related to the environment instead of host traits. Our study indicated that the extent of parasitism is rarely determined by a sole factor, but is an outcome of complex interactions among animal physiology, animal behavior, characteristics of parasites, and the environments.