Live or Let Die? The Court of Protection's Ground-Breaking Decision in M. v. N. (by her litigation friend, the Official Solicitor) and others [2015] EWCOP 76 (Fam.)

This case note examines the first case in which the Court of Protection authorised the withdrawal of life-sustaining nutrition and hydration from a patient in a minimally conscious state. It reflects on the judge’s stated view that the label given to the patient’s condition is not determinative, examines the significance and interpretation of the ‘best interests’ test, compares the court’s decision with that in a 2011 case with similar facts, and questions the law’s differing approaches to patients in the minimally conscious and ‘vegetative’ states. It concludes with a brief explanation of ways in which clinicians might – now and, subject to the robustness of emerging neuroimaging technology, in the future – be able to ascertain the views of people who cannot communicate in conventional ways, and expresses the hope that future judges will give priority to their patients’ wishes, to the extent that these can be ascertained

Barriers to older adults’ uptake of mobile-based mental health interventions

Background To address increasing demand of mental healthcare treatments for older adults and the need to reduce delivery costs, healthcare providers are turning to mobile applications. The importance of psychological barriers have been highlighted in the uptake of mobile-based mental health interventions and efforts have been made to identify these barriers in order to facilitate initial uptake and acceptance. However, limited research has focused on older adults’ awareness of these applications and factors that might be hindering their use. Objective The purpose of this study was to explore the perceived barriers that older adults experience in the uptake of mobile-based mental health interventions. Methods Semi-structured interviews were conducted with a sample of 10 older adults, 50 years or older (female = 7, mean age = 68 years), who experienced periods of low mood. National Health Service applications were demonstrated to facilitate conversation and explore participants’ understanding of mental health and mobile-based mental health interventions. Thematic analysis was used to analyse the interview transcripts. Results The social ecological model was adopted as an organising framework for the thematic analysis which identified six distinct barriers to older adults’ uptake of mobile-based mental health interventions: mental electronic-health (e-health) awareness, interaction with technology, discontinuation, ‘seeing’ facilitates therapeutic alliance, incongruent role of the general practitioner and privacy and confidentiality. Conclusions Older adults experience a number of barriers to uptake ranging from the individual level to a macro, organisational level. The practical implications of these barriers are discussed such as the need for increased awareness of mobile-based mental health interventions among older adults

Radiative forcing and climate change

Aviation causes climate change as a result of its emissions of CO2, oxides of nitrogen, aerosols, and water vapor. One simple method of quantifying the climate impact of past emissions is radiative forcing. The radiative forcing due to changes in CO2 is best characterized, but there are formidable difficulties in estimating the non-CO2 forcings – this is particularly the case for possible aviation-induced changes in cloudiness (AIC). The most recent comprehensive assessment gave a best estimate of the 2005 total radiative forcing due to aviation of about 55–78 mW m−2 depending on whether AIC was included or not, with an uncertainty of at least a factor of 2. The aviation CO2 radiative forcing represents about 1.6% of the total CO2 forcing from all human activities. It is estimated that, including the non-CO2 effects, aviation contributes between 1.3 and 14% of the total radiative forcing due to all human activities. Alternative methods for comparing the future impact of present-day aviation emissions are presented – the perception of the relative importance of the non-CO2 emissions, relative to CO2, depends considerably on the chosen method and the parameters chosen within those methods

Functional privacy concerns of older adults about pervasive health-monitoring systems

Technologies designed to support ageing can be deemed to be ageist in that they often exhibit a benevolent paternalism that tries to ‘protect’ older people. Often this involves gathering extensive data to monitor physical and cognitive decline at the expense of an individual’s privacy, with an underlying, often implicit, assumption that older adults no longer need much privacy. We consider such issues in the context of a project which seeks to promote the well-being of older adults. We conducted interviews with 20 older adults (10 males, 10 females, mean age=73) to ask, under what health and wellbeing circumstances would they wish to protect their privacy? Using thematic analysis, we uncovered six distinct reasons why older adults want to maintain privacy: protection from harm, autonomy, to present a positive social identity, to break free from social norms, to protect others, and to protect their own self-concept. We conclude that privacy is a highly valued resource for older adults and one that enables them to live fulfilling lives. We consider the design implications of our findings, noting that designers should aim to protect privacy from the outset, rather than viewing privacy as a ‘bolt-on’ that would inhibit data collection under specific circumstances. These concerns speak to the ‘paternalism’ agenda, in that older adults should be considered as active agents in the management of their own data disclosures

Enhancing beetle and spider communities in agricultural grasslands: the roles of seed addition and habitat management

Over three years, a replicated block design was used to investigate the effects of seed mixtures (grasses only; grasses and legumes; grasses, legumes and non-legume forbs), establishment techniques and long term management on beetle and spider communities of grassland swards. We quantified trophic links between phytophagous beetles and their host plants to assess the effect of these seed mixtures and management practices on food web structure. When managed under low intensity cutting regimes the most diverse seed mixture supported the highest biomass of beetles and spiders (c. 3.6 kg ha−1). Species richness of predatory beetles, phytophagous beetles and spiders were all increased by the sowing of legumes, although the addition of other forbs tended to result in at most modest further increases in invertebrate species richness. Analysis of food web structure suggests that the number of host plants utilised by beetles was greatest within the most diverse seed mixtures, but that this declined rapidly after the establishment year. We demonstrate that by sowing cheap and simple seed mixtures agriculturally improved grasslands can be managed to support increased diversity of spiders and beetles. While seed mixtures do not necessarily need to be of the highest diversity to achieve these benefits, the inclusion of legumes does appear to be crucial. The lower costs of intermediate diversity seed mixtures increase appeal to farmers, increasing the likely uptake of these methodologies in voluntary agri-environment schemes

High fat diet rescues disturbances to metabolic homeostasis and survival in the Id2 null mouse in a sex-specific manner

Inhibitor of DNA binding 2 (ID2) is a helix-loop-helix transcriptional repressor rhythmically expressed in many adult tissues. Our previous studies have demonstrated that Id2 null mice have altered expression of circadian genes involved in lipid metabolism, altered circadian feeding behavior, and sex-specific enhancement of insulin sensitivity and elevated glucose uptake in skeletal muscle and brown adipose tissue. Here we further characterized the Id2−/− mouse metabolic phenotype in a sex-specific context and under low and high fat diets, and examined metabolic and endocrine parameters associated with lipid and glucose metabolism. Under the low-fat diet Id2−/− mice showed decreased weight gain, reduced gonadal fat mass, and a lower survival rate. Under the high-fat diet, body weight and gonadal fat gain of Id2−/− male mice was comparable to control mice and survival rate improved markedly. Furthermore, the high-fat diet treated Id2−/− male mice lost the enhanced glucose tolerance feature observed in the other Id2−/− groups, and there was a sex-specific difference in white adipose tissue storage of Id2−/− mice. Additionally, a distinct pattern of hepatic lipid accumulation was observed in Id2−/− males: low lipids on the low-fat diet and steatosis on the high-fat diet. In summary, these data provides valuable insights into the impact of Id2 deficiency on metabolic homeostasis of mice in a sex-specific manner

Wildlife-friendly farming increases crop yield: evidence for ecological intensification

Ecological intensification has been promoted as a means to achieve environmentally sustainable increases in crop yields by enhancing ecosystem functions that regulate and support production. There is, however, little direct evidence of yield benefits from ecological intensification on commercial farms growing globally important foodstuffs (grains, oilseeds and pulses). We replicated two treatments removing 3 or 8% of land at the field edge from production to create wildlife habitat in 50–60 ha patches over a 900 ha commercial arable farm in central England, and compared these to a business as usual control (no land removed). In the control fields, crop yields were reduced by as much as 38% at the field edge. Habitat creation in these lower yielding areas led to increased yield in the cropped areas of the fields, and this positive effect became more pronounced over 6 years. As a consequence, yields at the field scale were maintained—and, indeed, enhanced for some crops—despite the loss of cropland for habitat creation. These results suggested that over a 5-year crop rotation, there would be no adverse impact on overall yield in terms of monetary value or nutritional energy. This study provides a clear demonstration that wildlife-friendly management which supports ecosystem services is compatible with, and can even increase, crop yields

Creation of micro-topographic features: a new tool for introducing specialist species of calcareous grassland to restored sites?

Questions: What types of pre-sowing disturbance are most suitable to establish specialist forbs of calcareous grassland at previously agriculturally improved restored sites? What impact does management regime have on post-establishment abundance-dynamics? Location: Pegsdon Hills, Bedfordshire, UK. Methods: We set up a 4-yr experiment using a split-plot design to combine pre-sowing disturbance treatments at sub-plot level (undisturbed control, glyphosate spraying, harrowing, and creation of ridge-and-furrow features) with three post-establishment management regimes applied at main plot level in years 2–4, involving either summer cutting or summer cattle grazing, and presence or absence of spring sheep grazing, along with autumn cattle grazing in all regimes. After disturbance application, we sowed a seed mixture containing ten specialist species of calcareous grassland. Using quadrat-based methods, we monitored first-year establishment and subsequent dynamics, including reproductive status of species at quadrat level. Initial establishment and subsequent dynamics were analysed separately using LMM. Results: Initial establishment of sown species was promoted both by harrowing and by ridge-and-furrow creation. While some species were about equally promoted by both, several other species benefited more strongly or exclusively from ridge-and-furrow creation. Effects of disturbance largely persisted in subsequent years, but for some species, different dynamics were observed for harrowed and ridge-and-furrow treatments. Thymus pulegioides and Hippocrepis comosa gradually achieved higher abundances in the ridge-and-furrow treatment, in which notable levels of bare ground persisted for much longer than in the harrowed treatment. In contrast, Filipendula vulgaris and Pimpinella saxifraga achieved higher abundance in the harrowed treatment. Sown species tended to reach reproductive stage faster in the ridge-and-furrow treatment than in the harrowed treatment. By the end of the study, management regimes had resulted in few effects on species dynamics. Conclusions: Establishment of specialist species of calcareous grassland crucially depended on bare ground creation prior to sowing. Ridge-and-furrow creation resulted in more persistent reduction of competition than the standard practice of harrowing, provided more suitable conditions for low-statured specialist species, and generally enabled faster transition of introduced specialist species to reproductive stage. Our results thus illustrate potential benefits of using more severe disturbance when introducing specialist species of calcareous grassland at restored sites