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Background: Frailty is characterised by increased vulnerability to falls, disability, hospitalisation and care home admission. However, it is relatively reversible in the early stages. Older people living with frailty often have multiple health and social issues which are difficult to address but could benefit from proactive, person-centred care. Personalised care planning aims to improve outcomes through better self-management, care coordination and access to community resources., Methods: This feasibility cluster randomised controlled trial aims to recruit 400 participants from 11 general practice clusters across Bradford and Leeds in the north of England. Eligible patients will be aged over 65 with an electronic frailty index score of 0.21 (identified via their electronic health record), living in their own homes, without severe cognitive impairment and not in receipt of end of life care. After screening for eligible patients, a restricted 1:1 cluster-level randomisation will be used to allocate practices to the PROSPER intervention, which will be delivered over 12 weeks by a personal independence co-ordinator worker, or usual care. Following initial consent, participants will complete a baseline questionnaire in their own home including measures of health-related quality of life, activities of daily living, depression and health and social care resource use. Follow-up will be at six and 12 months. Feasibility outcomes relate to progression criteria based around recruitment, intervention delivery, retention and follow-up. An embedded process evaluation will contribute to iterative intervention optimisation and logic model development by examining staff training, intervention implementation and contextual factors influencing delivery and uptake of the intervention., Discussion: Whilst personalised care planning can improve outcomes in long-term conditions, implementation in routine settings is poor. We will evaluate the feasibility of conducting a cluster randomised controlled trial of personalised care planning in a community population based on frailty status. Key objectives will be to test fidelity of trial design, gather data to refine sample size calculation for the planned definitive trial, optimise data collection processes and optimise the intervention including training and delivery., Trial Registration: ISRCTN12363970 - 08/11/18., Competing Interests: Competing interestsThere are no financial or other competing interests for principal investigators for the overall trial and each study site., (© The Author(s) 2020.)

Phonetic categories must be learned, but the processes that allow that learning to unfold are still under debate. The current study investigates constraints on the structure of categories that can be learned and whether these constraints are speech-specific. Category structure constraints are a key difference between theories of category learning, which can roughly be divided into instance-based learning (i.e., exemplar only) and abstractionist learning (i.e., at least partly rule-based or prototype-based) theories. Abstractionist theories can relatively easily accommodate constraints on the structure of categories that can be learned, whereas instance-based theories cannot easily include such constraints. The current study included three groups to investigate these possible constraints as well as their speech specificity: English speakers learning German speech categories, German speakers learning German speech categories, and English speakers learning musical instrument categories, with each group including participants who learned different sets of categories. Both speech groups had greater difficulty learning disjunctive categories (ones that require an "or" statement) than nondisjunctive categories, which suggests that instance-based learning alone is insufficient to explain the learning of the participants learning phonetic categories. This fact was true for both novices (English speakers) and experts (German speakers), which implies that expertise with the materials used cannot explain the patterns observed. However, the same was not true for the musical instrument categories, suggesting a degree of domain-specificity in these constraints that cannot be explained through recourse to expertise alone.

Categorical perception, an increased sensitivity to between- compared with within-category contrasts, is a stable property of native speech perception that emerges as language matures. Although recent research suggests that categorical responses to speech sounds can be found in left prefrontal as well as temporo-parietal areas, it is unclear how the neural system develops heightened sensitivity to between-category contrasts. In the current study, two groups of adult participants were trained to categorize speech sounds taken from a dental/retroflex/velar continuum according to two different boundary locations. Behavioral results suggest that for successful learners, categorization training led to increased discrimination accuracy for between-category contrasts with no concomitant increase for within-category contrasts. Neural responses to the learned category schemes were measured using a short-interval habituation design during fMRI scanning. Whereas both inferior frontal and temporal regions showed sensitivity to phonetic contrasts sampled from the continuum, only the bilateral middle frontal gyri exhibited a pattern consistent with encoding of the learned category scheme. Taken together, these results support a view in which top-down information about category membership may reshape perceptual sensitivities via attention or executive mechanisms in the frontal lobes.

Purpose: To compare the amplitude, latency, morphology, and threshold of the auditory P300 using standard oddball and omitted paradigms., Research Design: P300 waveforms were measured from the Cz electrode site. Frequent stimuli for both paradigms were 1000 Hz tone bursts. Target stimuli for the standard oddball paradigm were 2000 Hz tone bursts and an omitted stimulus, or silent gap, for the omitted paradigm., Study Sample: Fifteen bilaterally normal-hearing young adults., Results: There were significantly lower amplitudes, poorer morphology, and higher thresholds for the P300 using an omitted paradigm compared to the standard oddball paradigm., Conclusion: These results suggest that the auditory P300 could have a larger exogenous component than traditionally thought.