Acclimation of thermal physiology to new basking regimes in a widespread Australian skink.

Changes in thermal environments are a challenge for many ectotherms, as they would have to acclimate their physiology to new thermal environments to maintain high-levels of performance. Time spent basking is key for many ectothermic animals to keep their body temperature within optimal thermal ranges. However, little is known about the impact of changes in basking time on the thermal physiology of ectothermic animals. We investigated how different basking regimes (low intensity vs high intensity) affected key thermal physiological traits of a widespread Australian skink (Lampropholis delicata). We quantified thermal performance curves and thermal preferences of skinks subjected to low and high intensity basking regimes over a 12-week period. We found that skinks acclimated their thermal performance breadth in both basking regimes, with the skinks from the low-intensity basking regime showing narrower performance breadths. Although maximum velocity and optimum temperatures increased after the acclimation period, these traits did not differ between basking regimes. Similarly, no variation was detected for thermal preference. These results provide insight into mechanisms that allow these skinks to successfully overcome environmental constraints in the field. Acclimation of thermal performance curves seems to be key for widespread species to colonise new environments, and can buffer ectothermic animals in novel climatic scenarios.

Biological invasions as a selective filter driving behavioral divergence.

Biological invasions are a multi-stage process (i.e., transport, introduction, establishment, spread), with each stage potentially acting as a selective filter on traits associated with invasion success. Behavior (e.g., exploration, activity, boldness) plays a key role in facilitating species introductions, but whether invasion acts as a selective filter on such traits is not well known. Here we capitalize on the well-characterized introduction of an invasive lizard (Lampropholis delicata) across three independent lineages throughout the Pacific, and show that invasion shifted behavioral trait means and reduced among-individual variation-two key predictions of the selective filter hypothesis. Moreover, lizards from all three invasive ranges were also more behaviorally plastic (i.e., greater within-individual variation) than their native range counterparts. We provide support for the importance of selective filtering of behavioral traits in a widespread invasion. Given that invasive species are a leading driver of global biodiversity loss, understanding how invasion selects for specific behaviors is critical for improving predictions of the effects of alien species on invaded communities.

How do the physiological traits of a lizard change during its invasion of an oceanic island?

Physiology is crucial for the survival of invasive species in new environments. Yet, new climatic conditions and the limited genetic variation found within many invasive populations may influence physiological responses to new environmental conditions. Here, we studied the case of the delicate skinks (Lampropholis delicata) invading Lord Howe Island (LHI), Australia. On LHI, the climate is different from the mainland source of the skinks, and independent introduction events generated invasive populations with distinct genetic backgrounds. To understand how climate and genetic background may shape physiological responses along biological invasions, we compared the physiological traits of a source and two invasive (single-haplotype and multi-haplotype) populations of the delicate skink. For each population, we quantified physiological traits related to metabolism, sprint speed, and thermal physiology. We found that, for most physiological traits analysed, population history did not influence the ecophysiology of delicate skinks. However, invasive populations showed higher maximum speed than the source population, which indicates that locomotor performance might be a trait under selection during biological invasions. As well, the invasive population with a single haplotype was less cold-tolerant than the multi-haplotype and source populations. Our results suggest that limited genetic variability and climate may influence physiological responses of invasive organisms in novel environments. Incorporating the interplay between genetic and physiological responses into models predicting species invasions can result in more accurate understanding of the potential habitats those species can occupy.

Avian predation intensity as a driver of clinal variation in colour morph frequency.

Phenotypic variation provides the framework for natural selection to work upon, enabling adaptive evolution. One of the most discernible manifestations of phenotypic variability is colour variation. When this variation is discrete, genetically based colour pattern morphs occur simultaneously within a population. Why and how colour polymorphisms are maintained is an evolutionary puzzle. Several evolutionary drivers have been hypothesized as influencing clinal patterns of morph frequency, with spatial variation in climate and predation being considered especially important. Despite this, no study has examined both of their roles simultaneously. The aims of this study were to: (a) examine the covariation of physiology, environmental variables and colouration at a local scale; and (b) determine if these factors and their interplay explain broad clinal variation in morph frequency. We used the lizard Liopholis whitii as a model system, as this species displays a discrete, heritable polymorphism for colour pattern (plain-backed, patterned morphs) whose morph frequency varies latitudinally. We measured reflectance, field activity temperatures and microhabitat structure to test for differences in crypsis, thermal biology and microhabitat selection of patterned and plain-backed morphs within a single population where colour morphs occur sympatrically. We then used data from the literature to perform a broad-scale analysis to identify whether these factors also explained the latitudinal variation of morph frequency in this species. At the local scale, plain-backed morphs were found to be less cryptic than patterned morphs while no other differences were detected in terms of thermal biology, dorsal reflectance and microhabitat use. At a broader scale, predation was the most influential factor mediating morph frequency across latitudes. However, the observed pattern of morph frequency is opposite to what the modelling results suggest in that the incidence of the least cryptic morph is highest where predation pressure is most severe. Clinal variation in the level of background matching between morphs or the potential reproductive advantage by the plain-backed morph may, instead, be driving the observed morph frequency. Together, these results provide key insights into the evolution of local adaptation as well as the ecological forces involved in driving the dynamics of colour polymorphism.

Does personality influence learning? A case study in an invasive lizard.

Learning is a change in state resulting from new experiences enabling behavioural responses to be adjusted in alignment with external cues. Individuals differ in the speed and accuracy at which they learn. Personality has been postulated as being a major influence on learning ability in terms of attention and encounter rates of environmental cues. This link forms the basis of the cognitive style hypothesis (CSH), predicting that an individual's cognitive style will occur along a fast-slow behavioural gradient. Fast types are characterised as being active, neophilic, and bold individuals who sample their environment rapidly, yet superficially, enabling learning to occur at a higher speed, but at the cost of accuracy. Slow types have the opposite suite of personality traits resulting in them being more accurate flexible learners. Greater level of learning flexibility is thought to help promote invasions success. Here, we test the predictions of the CSH in an invasive lizard (Lampropholis delicata) to determine if personality dictates learning performance in a two-phase associative task. Results indicated that the delicate skink was capable of learning an associative task but only provided partial support for the CSH. Personality was found to influence learning accuracy, however, the direction of that relationship was opposite to that predicted. Instead, fast lizards made fewer mistakes when learning to associate a colour to a goal. These findings highlight the need to further investigate the CSH across taxa and consider its potential as an underlying mechanism of the invasion process.

Thermal physiology: A new dimension of the pace-of-life syndrome.

Current syndrome research focuses primarily on behaviour with few incorporating components of physiology. One such syndrome is the pace-of-life syndrome (POLS) which describes covariation between behaviour, metabolism, immunity, hormonal response, and life-history traits. Despite the strong effect temperature has on behaviour, thermal physiology has yet to be considered within this syndrome framework. We proposed the POLS to be extended to include a new dimension, the cold-hot axis. Under this premise, it is predicted that thermal physiology and behaviour would covary, whereby individual positioning along the thermal continuum would coincide with that of the behavioural continuum. This hypothesis was tested by measuring thermal traits of delicate skinks (Lampropholis delicata) and linking it to their behaviour. Principal components analysis and structural equation modelling were used to determine if traits were structured within the POLS and to characterize the direction of their interactions. Model results supported the inclusion of the cold-hot axis into the POLS and indicated that thermal physiology was the driver of this relationship, in that thermal traits either constrained or promoted activity, exploration, boldness and social behaviour. This study highlights the need to integrate thermal physiology within a syndrome framework.

Repeatability and correlation of physiological traits: Do ectotherms have a "thermal type"?

Across a range of taxa, individuals within a species differ in suites of correlated traits. These trait complexes, known as syndromes, can have dramatic evolutionary consequences as they do not evolve independently but rather as a unit. Current research focuses primarily on syndromes relating to aspects of behavior and life history. What is less clear is whether physiological traits also form a syndrome. We measured 10 thermal traits in the delicate skink, Lampropholis delicata, to test this idea. Repeatability was calculated and their across-context correlations evaluated. Our results were in alignment with our predictions in that individual thermal traits varied consistently and were structured into a physiological syndrome, which we are referring to as the thermal behavior syndrome (TBS). Within this syndrome, lizards exhibited a "thermal type" with each being ranked along a cold-hot continuum. Hot types had faster sprint speeds and higher preferred body temperatures, whereas the opposite was true for cold types. We conclude that physiological traits may evolve as a single unit driven by the need to maintain optimal temperatures that enable fitness-related behaviors to be maximized.

The effect of skin reflectance on thermal traits in a small heliothermic ectotherm.

Variation in colour patterning is prevalent among and within species. A number of theories have been proposed in explaining its evolution. Because solar radiation interacts with the pigmentation of the integument causing light to either be reflected or absorbed into the body, thermoregulation has been considered to be a primary selective agent, particularly among ectotherms. Accordingly, the colour-mediated thermoregulatory hypothesis states that darker individuals will heat faster and reach higher thermal equilibria while paler individuals will have the opposite traits. It was further predicted that dark colouration would promote slower cooling rates and higher thermal performance temperatures. To test these hypotheses we quantified the reflectance, selected body temperatures, performance optima, as well as heating and cooling rates of an ectothermic vertebrate, Lampropholis delicata. Our results indicated that colour had no influence on thermal physiology, as all thermal traits were uncorrelated with reflectance. We suggest that crypsis may instead be the stronger selective agent as it may have a more direct impact on fitness. Our study has improved our knowledge of the functional differences among individuals with different colour patterns, and the evolutionary significance of morphological variation within species.

Nursing intervention versus usual care to improve delirium among home-dwelling older adults receiving homecare after hospitalization: feasibility and acceptability of a Randomized Controlled Trail.

BACKGROUND: Delirium is an acute cognitive impairment among older hospitalized patients. It can persist until discharge and for months after that. Despite proof that evidence-based nursing interventions are effective in preventing delirium in acute hospitals, interventions among home-dwelling older patients is lacking. The aim was to assess feasibility and acceptability of a nursing intervention designed to detect and reduce delirium in older adults after discharge from hospital. METHODS: Randomized clinical pilot trial with a before/after design was used. One hundred and three older adults were recruited in a home healthcare service in French-speaking Switzerland and randomized into an experimental group (EG, n = 51) and a control group (CG, n = 52). The CG received usual homecare. The EG received usual homecare plus five additional nursing interventions at 48 and 72 h and at 7, 14 and 21 days after discharge. These interventions were tailored for detecting and reducing delirium and were conducted by a geriatric clinical nurse (GCN). All patients were monitored at the start of the study (M1) and throughout the month for symptoms of delirium (M2). This was documented in patients' records after usual homecare using the Confusion Assessment Method (CAM). At one month (M2), symptoms of delirium were measured using the CAM, cognitive status was measured using the Mini-Mental State Examination (MMSE), and functional status was measured using Katz and Lawton Index of activities of daily living (ADL/IADL). At the end of the study, participants in the EG and homecare nurses were interviewed about the acceptability of the nursing interventions and the study itself. RESULTS: Feasibility and acceptability indicators reported excellent results. Recruitment, retention, randomization, and other procedures were efficient, although some potentially issues were identified. Participants and nurses considered organizational procedures, data collection, intervention content, the dose-effect of the interventions, and methodology all to be feasible. Duration, patient adherence and fidelity were judged acceptable. Nurses, participants and informal caregivers were satisfied with the relevance and safety of the interventions. CONCLUSIONS: Nursing interventions to detect/improve delirium at home are feasible and acceptable. These results confirm that developing a large-scale randomized controlled trial would be appropriate. TRIAL REGESTRATION: ISRCTN registry no: 16103589 - 19 February 2016.

Association between frailty and delirium in older adult patients discharged from hospital.

BACKGROUND: Delirium and frailty - both potentially reversible geriatric syndromes - are seldom studied together, although they often occur jointly in older patients discharged from hospitals. This study aimed to explore the relationship between delirium and frailty in older adults discharged from hospitals. METHODS: Of the 221 patients aged >65 years, who were invited to participate, only 114 gave their consent to participate in this study. Delirium was assessed using the confusion assessment method, in which patients were classified dichotomously as delirious or nondelirious according to its algorithm. Frailty was assessed using the Edmonton Frailty Scale, which classifies patients dichotomously as frail or nonfrail. In addition to the sociodemographic characteristics, covariates such as scores from the Mini-Mental State Examination, Instrumental Activities of Daily Living scale, and Cumulative Illness Rating Scale for Geriatrics and details regarding polymedication were collected. A multidimensional linear regression model was used for analysis. RESULTS: Almost 20% of participants had delirium (n=22), and 76.3% were classified as frail (n=87); 31.5% of the variance in the delirium score was explained by frailty (R (2)=0.315). Age; polymedication; scores of the Confusion Assessment Method (CAM), instrumental activities of daily living, and Cumulative Illness Rating Scale for Geriatrics; and frailty increased the predictability of the variance of delirium by 32% to 64% (R (2)=0.64). CONCLUSION: Frailty is strongly related to delirium in older patients after discharge from the hospital.

An Intervention to Promote Breast Milk Production in Mothers of Preterm Infants.

A pilot study was conducted to estimate the effects of a breast milk expression education and support intervention on breast milk production outcomes in mothers of very and extremely preterm infants. Forty mothers of hospitalized preterm infants (<30 weeks of gestation) were randomized to the experimental intervention or standard care for 6 weeks. Duration and frequency of breast milk expressions and volume of expressed breast milk were measured daily. Samples of breast milk were collected thrice during the study and analyzed for their lipid concentration. Mothers in the experimental group had a statistically significant higher duration of breast milk expression in min/day (p= .043). Differences observed between the two groups regarding the frequency of breast milk expression, volume of breast milk, and lipid concentration were not statistically significant. Results suggest that the experimental intervention may promote breast milk production in mothers of very and extremely preterm infants.

Nursing discharge planning for older medical inpatients in Switzerland: A cross-sectional study.

Nursing discharge planning for elderly medical inpatients is an essential element of care to ensure optimal transition to home and to reduce post-discharge adverse events. The objectives of this cross-sectional study were to investigate the association between nursing discharge planning components in older medical inpatients, patients' readiness for hospital discharge and unplanned health care utilization during the following 30 days. Results indicated that no patients benefited from comprehensive discharge planning but most benefited from less than half of the discharge planning components. The most frequent intervention recorded was coordination, and the least common was patients' participation in decisions regarding discharge. Patients who received more nursing discharge components felt significantly less ready to go home and had significantly more readmissions during the 30-day follow-up period. This study highlights large gaps in the nursing discharge planning process in older medical inpatients and identifies specific areas where improvements are most needed.

Translation and psychometric evaluation of a French version of the Readiness for Hospital Discharge Scale.

AIMS AND OBJECTIVES: To evaluate the reliability and the factor structure of the Readiness for Hospital Discharge Scale-French version. BACKGROUND: The patient's perspective is essential when assessing risk for adverse events at hospital discharge. Developed in the USA, the Readiness for Hospital Discharge Scale is the only instrument that measures an individual's self-perception of readiness before leaving the hospital. A French version of the Readiness for Hospital Discharge Scale was developed and validated. DESIGN: Cross-sectional study. METHODS: A convenience sample of 265 older inpatients from four medical units was selected. The translation and cultural adaptation of the scale involved experts in gerontology and the French language and included back translation. The items were semantically evaluated and pretested in 10 older inpatients. The scale's psychometric properties were internally validated by using confirmatory and exploratory factor analyses. Reliability was assessed by examining the internal consistency of its items. RESULTS: Goodness-of-fit indices of the confirmatory factor analyses were not adequate, but reliability was acceptable (Cronbach's α = 0·80). Exploratory factor analysis of the French version provided results close to those described for the English version, with three similar subscales (physical and emotional readiness, coping with medical treatment and personal care), whereas the initially described Expected Support subscale was not identified in the French version. CONCLUSION: The Readiness for Hospital Discharge Scale-French version appears to be partially consistent with its original English version, but requires additional adaptation to fully take into account the Swiss context and culture to achieve its original aim. RELEVANCE TO CLINICAL PRACTICE: Assessing patient readiness for hospital discharge before leaving hospital could help nurses to improve the discharge planning process and achieve better patient preparedness and care coordination.

Effect Estimation of an Innovative Nursing Intervention to Improve Delirium among Home-Dwelling Older Adults: A Randomized Controlled Pilot Trial.

AIMS: Estimating the effect of a nursing intervention in home-dwelling older adults on the occurrence and course of delirium and concomitant cognitive and functional impairment. METHODS: A randomized clinical pilot trial using a before/after design was conducted with older patients discharged from hospital who had a medical prescription to receive home care. A total of 51 patients were randomized into the experimental group (EG) and 52 patients into the control group (CG). Besides usual home care, nursing interventions were offered by a geriatric nurse specialist to the EG at 48 h, 72 h, 7 days, 14 days, and 21 days after discharge. All patients were monitored for symptoms of delirium using the Confusion Assessment Method. Cognitive and functional statuses were measured with the Mini-Mental State Examination and the Katz and Lawton Index. RESULTS: No statistical differences with regard to symptoms of delirium (p = 0.085), cognitive impairment (p = 0.151), and functional status (p = 0.235) were found between the EG and CG at study entry and at 1 month. After adjustment, statistical differences were found in favor of the EG for symptoms of delirium (p = 0.046), cognitive impairment (p = 0.015), and functional status (p = 0.033). CONCLUSION: Nursing interventions to detect delirium at home are feasible and accepted. The nursing interventions produced a promising effect to improve delirium.

Acceptability and feasibility of a breast milk expression education and support intervention in mothers of preterm infants.

PURPOSE: A pilot study was conducted to assess the acceptability and feasibility of a breast milk expression education and support intervention in mothers of preterm infants and study procedures. SUBJECTS: Forty mothers of preterm infants born at less than 30 weeks of gestation. DESIGN: Pilot randomized controlled trial. METHODS: Mothers of preterm infants were randomly allocated to the breast milk expression education and support intervention or standard care. The experimental intervention encompassed a breast milk expression education session on 7 themes, telephone follow-up, and telephone helpline. MAIN OUTCOME MEASURES: Data related to the acceptability and feasibility of the intervention and study procedures were collected throughout the study. At the end of the study, mothers allocated to the experimental intervention completed a self-report questionnaire assessing the acceptability of each of the intervention components. RESULTS: It was feasible to recruit 70% of eligible mothers and retain 83% of mothers who consented to participate in the study. Mothers reported that all the intervention components were appropriate and effective in supporting their breast milk production. Although the reliability of the data collection method was demonstrated, the fidelity of the telephone follow-up faced some challenges. CONCLUSIONS: Both the intervention and study procedures were acceptable and feasible. Improvements related to the fidelity of the intervention would ensure the feasibility and internal validity of a larger-scale trial.

Advance care planning for institutionalised older people: an integrative review of the literature.

BACKGROUND: This integrative review of the literature describes the evolution in knowledge and the paradigm shift that is necessary to switch from advance directives to advance care planning. AIMS AND OBJECTIVES: It presents an analysis of concepts, trends, models and experiments that enables identification of the best treatment strategies, particularly for older people living in nursing homes. DESIGN: Based on 23 articles published between 1999 and 2012, this review distinguishes theoretical from empirical research and presents a classification of studies based on their methodological robustness (descriptive, qualitative, associative or experimental). RESULTS: It thus provides nursing professionals with evidence-based information in the form of a synthetic vision and conceptual framework to support the development of innovative care practices in the end-of-life context. While theoretical work places particular emphasis on the impact of changes in practice on the quality of care received by residents, empirical research highlights the importance of communication between the different persons involved about care preferences at the end of life and the need for agreement between them. CONCLUSIONS: The concept of quality of life and the dimensions and factors that compose it form the basis of Advance care planning (ACP) and enable the identification of the similarities and differences between various actors. They inform professionals of the need to ease off the biomedical approach to consider the attributes prioritised by those concerned, whether patients or families, so as to improve the quality of care at the end of life. IMPLICATIONS FOR PRACTICE: It is particularly recommended that all professionals involved take into account key stakeholders' expectations concerning what is essential at the end of life, to enable enhanced communication and decision-making when faced with this difficult subject.

Intervention minimizing preterm infants' exposure to NICU light and noise.

Neonatal intensive care unit (NICU) light and noise may be stressful to preterm infants. This research evaluated the physiological stability of 54 infants born at 28- to 32-weeks' gestational age while wearing eye goggles and earmuffs for a 4-hour period in the NICU. Infants were recruited from four NICUs of university-affiliated hospitals and randomized to the intervention-control or control-intervention sequences. Heart rate (HR), heart rate variability (HRV), and oxygen saturation (O2 sat) were collected using the SomtéTM device. Confounding variables such as position and handling were assessed by videotaping infants during the study periods. Results indicated that infants had more stress responses while wearing eye goggles and earmuffs since maximum HR was found to be significantly higher and high-frequency power of HRV significantly lower during the intervention as compared with the control period. Therefore, this intervention is not recommended for the clinical practice.

Infant and maternal factors influencing breastmilk sodium among primiparous mothers.

OBJECTIVE: This study identified birth events and infant/maternal factors related to breastmilk sodium (Na+) among primiparous mothers. SUBJECTS AND METHODS: Data were collected in a larger study on perceived insufficient milk among 252 breastfeeding mothers at a Canadian, French-speaking university maternal care center. Birth events and infant and maternal factors were collected at 48 hours, 2 weeks, and 6 weeks after birth and were analyzed with bivariate and regression analysis. RESULTS: Presence of gestational diabetes increases the risk of an elevated breastmilk Na+ level at 48 hours, and increased number of breastfeeds (mean=8.91, SD=3.77) lowers it, indicating lactogenesis II was initiated. CONCLUSIONS: Breastfeeding frequency impacts initiation of lactogenesis II, which in turn influences duration of breastfeeding exclusivity. Therefore feedings should be promoted as soon as possible after birth and as frequently as eight to 12 times a day.

Maternal touch and talk for invasive procedures in infants and toddlers in the pediatric intensive care unit.

The aim of this single-blind, randomized, crossover trial was to test the effect of Touch & Talk (T&T) for infants and toddlers less than 36 months of age (N = 65) in the pediatric intensive care unit on their physiological stability and recovery to an invasive procedure. In the T&T condition, mothers touched, sang, or told stories or rhymes to their child during an invasive procedure. In the control condition, the mothers did not have contact with their child. Physiological measures included heart rate, heart rate variability, and oxygen saturation range during the procedure and change from baseline. Time from the end of the procedure until the heart rate returned to baseline levels gave the recovery time. Analysis was conducted using repeated-measures analysis of covariance. There were no significant differences on any of the physiological parameters by condition during the procedure. However, when controlling for severity of illness, recovery was faster with mothers.