Person-centred care on the move - an interview study with programme directors in Swedish higher education.

BACKGROUND: There is an increasing trend towards person-centred care (PCC) worldwide, suggesting that PCC should be mastered by future health care professionals. This study aims to explore programme directors' views on facilitators and barriers to implementing PCC in four of the largest national study programmes in Sweden training future health care professionals. METHODS: A qualitative design was applied and interviews were conducted with 19 programme directors of Swedish national study programmes in medicine, nursing, occupational therapy and physiotherapy. The interviews were analysed using qualitative content analysis. Themes were sorted according to the Consolidated Framework for Implementation Research (CFIR) in an abductive approach. COREQ guidelines were applied. RESULTS: The overarching theme, as interpreted from the programme directors' experiences, was 'Person-centred care is on the move at different paces.' The theme relates to the domains identified by the CFIR as outer setting, innovation, inner setting and process. PCC was understood as something familiar but yet new, and the higher education institutions were in a state of understanding and adapting PCC to their own contexts. The movement in the outer setting consists of numerous stakeholders advocating for increased patient influence, which has stirred a movement in the inner setting where the higher educational institutions are trying to accommodate these new demands. Different meanings and values are ascribed to PCC, and the concept is thus also 'on the move', being adapted to traditions at each educational setting. CONCLUSION: Implementation of PCC in Swedish higher education is ongoing but fragmented and driven by individuals with a specific interest. There is uncertainty and ambiguity around the meaning and value of PCC and how to implement it. More knowledge is needed about the core of PCC as a subject for teaching and learning and also didactic strategies suitable to support students in becoming person-centred practitioners.

Large males fight and court more across a range of social environments: an experiment on the two spotted goby Gobiusculus flavescens.

The present study explored how male size relates to mating competition across a natural range of male and female densities in the two-spotted goby Gobiusculus flavescens. Across this range of social environments, large males were more than twice as likely as small ones to chase other males, to become nest-holders, and to court females, but large males were not significantly more likely to engage in agonistic fin displays. Overall, the study showed that large males court and fight more than small ones across a wide, yet natural, span of social environments. Having a large body size appears to confer competitive advantage for males in any social environment of the study species. Further studies are needed to disentangle whether the benefit of large size is mainly in competition over resources, over matings as such, or both.

First record of a Kabatana sp. microsporidium infecting fish in the Atlantic Ocean.

Two-spotted goby Gobiusculus flavescens from the Swedish Gullmarsfjord regularly present subcutaneous creamy-white patches in the body musculature, associated with Kabatana sp. infection. Analysis of the 16S rRNA gene of the microsporidium showed 98.54% homology with Kabatana newberryi infecting a marine goby from California, indicating that the Swedish microsporidium is either a different strain of K. newberryi or a closely related species. This represents the first record of a Kabatana species in the Atlantic Ocean. The genetic similarity of the 2 microsporidia was paralleled by close infection phenotypes. Infected muscle fibres were swollen compared to adjacent non-infected fibres, and mature spore masses were found throughout the skeletal musculature. No xenoma formation was detected. Since G. flavescens is an established model species in behavioural ecology, the host-parasite system is ideally suited for testing how microsporidian infections affect host behaviour and fitness.

Female ornamentation and egg carotenoids of six sympatric gobies.

Belly colouration, gonad carotenoid concentration and skin transparency were quantified in gravid Gobiusculus flavescens, as well as in females of five sympatric gobies where belly ornamentation has not been described. Although G. flavescens females did, indeed, have far more colourful bellies than the other species, this could only in part be explained by a high concentration of total gonad carotenoids. Comparable, or occasionally higher, carotenoid levels were found in the gonads of other species. Instead, the unusual ornamentation of G. flavescens arises from a unique combination of carotenoid-rich gonads and a highly transparent abdominal skin.

Male mate choice selects for female coloration in a fish.

Although sexual selection theory has proved successful in explaining a wide array of male ornaments, the function of ornaments occurring in females is largely unknown. Traditionally, female ornaments have been considered nonfunctional, being merely a genetically correlated response to selection for male ornamentation. However, this hypothesis is only relevant to species in which the ornament is basically the same in the two sexes. Alternatively, female ornaments may be influenced by selection acting directly on the females, either through female-female competition or male choice. We tested the latter hypothesis in mate-choice experiments with two-spotted gobies (Gobiusculus flavescens). In this small marine fish, females have bright yellow-orange bellies during the breeding season, a conspicuous trait that is not present in males. We conducted two aquarium experiments to test whether males preferred to mate with more colorful females. In the first experiment, males had a choice between two females that varied in natural coloration (and belly roundness). In the second experiment, we manipulated belly coloration and kept roundness constant. Males spent more time with colorful than with drab females in both experiments and also performed far more courtship displays toward colorful females. Our study provides experimental evidence that males prefer ornamented females in a fish that is not sex-role reversed, supporting the hypothesis that female ornamentation is sexually selected.

Parental behaviour in relation to food availability in the common goby.

In the common goby, Pomatoschistus microps (Pisces, Gobiidae), males build nests under mussel shells where they care for the eggs until hatching. To investigate why male common gobies cannibalize their own eggs (filial cannibalism), we conducted a feeding experiment. Males given little food ate from their eggs more often than males given food in excess. However, males given mussel meat in excess did not eat more of their eggs than males fed with both mussel meat in excess and goby eggs. This may suggest that male common gobies cannibalize their eggs to obtain energy rather than essential nutrients lacking in other diets. Moreover, males ate their whole clutch if it was exceptionally small regardless of food treatment, suggesting that males stop investing in their clutch if its reproductive value is less than the cost of guarding it. Thus, whole clutch cannibalism and partial clutch cannibalism seem to be governed by different factors. Furthermore, poorly built nests were associated with starved males, suggesting that nest concealing is costly. There was an association between how well the nest was built and partial clutch filial cannibalism, suggesting that the appearance of the nest may indicate the condition of the male, and thus the risk of filial cannibalism. Copyright 1998 The Association for the Study of Animal Behaviour.

Parental behaviour in relation to the occurrence of sneaking in the common goby.

To investigate whether male common gobies, Pomatoschistus microps (Pisces, Gobiidae), treat their offspring differently depending on confidence of paternity, we conducted an experiment in which randomly chosen males either spawned alone with a female, or with a sneaking male present. Males did not treat their brood differently whether they had experienced sneaking or not. Our estimates of parental care, nest defence against potential egg predators and fanning rate were the same for the two treatments. Furthermore, there was no difference in filial cannibalism (eating their own progeny) between males that had been sneaked upon and males that had not. However, nest-guarding males that ate some of their brood had a smaller original brood area than other males. This suggests either an increase in paternal expenditure with increased brood size or a threshold value (absolute brood size or proportion of nest space covered) above which males do not cannibalize eggs. Copyright 1998 The Association for the Study of Animal Behaviour.

Should females prefer dominant males?

It is generally believed that success in male-male competition genuinely reflects high quality and that female preference for dominant males should therefore be widespread. However, recent studies suggest that male dominance is not always attractive and that it does not necessarily predict superior parental quality, better genes or other forms of benefit to females. In fact, the costs of choosing a dominant male can sometimes outweigh the benefits. When traits selected by male-male competition do not reflect overall mate quality, females are expected to use other choice cues and might occasionally prefer subordinate males. Thus, male-male competition and female choice can sometimes work in different, or even opposing, directions.