Family Involvement Training for Staff and Family Caregivers: Case Report on Program Design and Mixed Methods Evaluation.

The COVID-19 pandemic underscored the imperative for meaningful family involvement in long-term care, aligning with policy and safety standards while enhancing outcomes for caregivers, residents, and staff. The objectives of this article are as follows: (1) a case study report on implementing a family involvement intervention designed to facilitate the formal and safe engagement of family caregivers in resident care and (2) the pilot evaluation of the intervention. We used Knapp's six-step implementation science model to guide and describe intervention development to provide insight for others planning family involvement projects. We employed sequential mixed methods, including surveys with quantitative and qualitative questions before and after program implementation for providers, and surveys and interviews with family caregivers a year after. We used the Mann-Whitney U test (p < 0.05) to assess differences in health providers' perceptions pre- and post-education. Families and staff perceived that the Family Involvement Program was important for improving the quality of care, residents' quality of life and family/staff relationships. Providers' perceptions of the program's positive impact on residents' quality of life (p = 0.020) and quality of care (p = 0.010), along with their satisfaction with working relationships with families (p = 0.039), improved significantly after the program. Qualitative data confirmed improvements in family-staff relationships. In conclusion, we documented the design of this family involvement initiative to encourage family caregivers and staff to work together in residents' care. Youville's Family Involvement Program gives families and family caregivers an explicit role as partners in long-term care. The mixed methods pilot evaluation documented improvements in staff and family relationships.

Immune profiles vary seasonally, but are not significantly related to migration distance or natal dispersal, in a migratory songbird.

A central tenet of ecoimmunology is that an organism's environment shapes its optimal investment in immunity. For example, the benefits of acquired (relatively pathogen specific) versus innate (nonspecific) immune defenses are thought to vary with the risk of encountering familiar versus unfamiliar pathogens. Because pathogen communities vary geographically, individuals that travel farther during seasonal migration or natal dispersal are predicted to have higher exposure to novel pathogens, and lower exposure to familiar pathogens, potentially favoring investment in innate immunity. During the breeding season, migratory animals' exposure to familiar pathogens should increase, potentially favoring investment in acquired immunity. We hypothesized that song sparrows Melospiza melodia adjust their constitutive immune profiles in response to risk of encountering novel versus familiar pathogens. We predicted that individuals migrating longer distances (inferred from stable hydrogen isotope analysis of claws) and less philopatric individuals (inferred from microsatellite assignment testing) would rely more heavily on acquired than innate defenses. We also predicted that reliance on acquired defenses would increase throughout the early breeding season. Consistent with trade-offs between acquired and innate defenses, levels of immunoglobulin Y (acquired) varied negatively with macrophage phagocytosis activity (innate). Levels of acquired relative to innate immunity did not vary significantly with migration distance or philopatry, but increased throughout the early breeding season. Macrophage phagocytosis was not significantly repeatable between years. Song sparrows appear to shift from innate defenses immediately after migration to acquired defenses with increasing time at the breeding grounds. These patterns highlight the plasticity of constitutive immune defenses in migratory animals.

Effects of sex and seasonality on the song control system and FoxP2 protein expression in black-capped chickadees (Poecile atricapillus).

Plasticity in behavior is mirrored by corresponding plasticity in the brain in many songbird species. In some species, song system nuclei (Phillmore et al. [2006]: J Neurobiol 66:1002-1010) are larger in birds in breeding condition than birds in nonbreeding condition, possibly due to increased vocal output in spring. FOXP2, a transcription factor associated with language expression and comprehension in humans and song learning in songbirds, also shows plasticity. FoxP2 expression in songbird Area X, a region important for sensorimotor integration, is related to developmental and adult vocal plasticity (Teramitsu et al. [2010]: J Neurosci 24:3152-3163, Chen et al. [2013], J Exp Biol 216:3682-3692). In this study, we examined whether sex and breeding condition affects both song control system volume (HVC, X) and FoxP2 protein expression in black-capped chickadees (Poecile atricapillus). HVC volume was larger in males in breeding condition than males in nonbreeding condition, but there were no sex differences. In contrast, Area X volume was larger in males than females, regardless of breeding condition, likely reflecting that male and female chickadees produce learned chick-a-dee calls year round, but output of the learned song increases in breeding males. FoxP2 protein levels did not differ between sexes or breeding condition when calculated as a ratio of labeled cells in Area X to labeled cells in the surrounding striato-pallium, however, absolute density of FoxP2 in both regions was higher in males than in females. This may indicate that chickadees maintain a level of FoxP2 necessary for plasticity year-round, but males have greater potential for plasticity compared to females.