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Establishment and initial implementation of the Australasian Pelvic Floor Procedure Registry. Int Urogynecol J 2023; 34:1697-1704. [PMID: 36695860 PMCID: PMC10415488 DOI: 10.1007/s00192-022-05435-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/30/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are common pelvic floor disorders (PFDs). Owing to significant adverse events associated with mesh-related pelvic floor procedures (PFPs) in a proportion of the surgically treated population, and deficits in collection and reporting of these events, the Australian Government identified an urgent need for a tracking mechanism to improve safety and quality of care. The Australasian Pelvic Floor Procedure Registry (APFPR) was recently established following the 2018 Senate Committee Inquiry with the aim of tracking outcomes of PFP involving the use of devices and/or prostheses, with the objective of improving the health outcomes of women who undergo these procedures. This paper will describe the APFPR's aims, development, implementation and possible challenges on the way to its establishment. METHODS The APFPR has been developed and implemented in accordance with the national operating principles of clinical quality registries (CQRs). The minimum datasets (MDS) for the registry's database have been developed using a modified Delphi process, and data are primarily being collected from participating surgeons. Patient recruitment is based on an opt-out approach or a waiver of consent. Patient-reported outcome measures (PROMs) providing additional health and outcome information will be obtained from participating women to support safety monitoring of mesh-related adverse events. RESULTS Currently in the Australasian Pelvic Floor Procedure Registry (APFPR) there are 32 sites from various jurisdictions across Australia, that have obtained relevant ethics and governance approvals to start patient recruitment and data collection as of January 2023. Additionally, there are two sites that are awaiting governance review and five sites that are having documentation compiled for submission. Seventeen sites have commenced patient registration and have entered data into the database. Thus far, we have 308 patients registered in the APFPR database. The registry also published its first status report and a consumer-friendly public report in 2022. CONCLUSIONS The registry will act as a systematic tracking mechanism by collecting outcomes on PFP, especially those involving devices and/or prostheses to improve safety and quality of care.
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Comparing consumer liking of beef from three feeding systems using a combination of traditional and temporal liking sensory methods. Food Res Int 2023; 168:112747. [PMID: 37120201 DOI: 10.1016/j.foodres.2023.112747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/16/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
Research on the effects of animal diet on consumer liking of beef has yielded conflicting results. Currently it is unknown whether dynamic changes occur in liking during consumption of beef. This study applied a combination of traditional and temporal (free and structured) liking methods to determine consumer liking of beef derived from animals that were fed grain (GF), grass silage plus grain (SG) or grazed grass (GG) during finishing. Three separate panels of beef eating consumers (n = 51; n = 52; n = 50) were recruited from Teagasc Food Research Centre, Dublin, Ireland to assess striploin steaks from animals fed either GF, SG, or GG. Using the free temporal liking (TL) method, results revealed that beef from GF animals was liked significantly less (p ≤ 0.05) in terms of overall liking, tenderness and juiciness, when compared to steaks from the SG and GG animals. These effects were not observed using the structured TL or traditional liking methods. Further analysis showed the evolution of scores over time was significant (p ≤ 0.05) for all attributes using the free TL method. Overall, the free TL method yielded more discriminative data and was perceived as easier to perform by consumers compared to the structured TL method. These results show that the free TL method may provide an opportunity to elicit more in-depth information regarding consumer sensory response to meat.
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CHALLENGES AND REWARDS EXPERIENCED IN THE VERY OLD PARENT-CHILD RELATIONSHIP: RELATIONSHIP QUALITY MATTERS. Innov Aging 2022. [PMCID: PMC9766980 DOI: 10.1093/geroni/igac059.2652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Very old parents and their “old” children are a growing group in industrialized countries worldwide. However, little is known about the nature and implications of this relationship constellation, especially the challenges and/or rewards experienced within the relationship. We therefore examined factors associated with perceptions of challenge and reward among very old parents and their children. Using data from 114 very old parent-child dyads in the Boston Aging Together Study, we estimated Actor-Partner Interdependence Models to predict challenge, reward, and challenge/reward ratio outcomes of dyad members as a function of relationship quality, support exchanges, family norms, and personality. Relationship quality emerged as the most influential predictor, albeit more consistently for children than for parents. When children experienced the parent-child relationship as more positive, both children and parents experienced fewer challenges and more rewards (i.e., both actor and partner effect). Parents’ experience of relationship quality was only associated with their own challenge perceptions (i.e., actor effect only). The roles of support exchanges, family norms, and personality were relatively minor, with few significant effects if at all. Given the importance of relationship quality for challenge and reward perceptions, support services or interventions targeting relationship quality could be a key pathway to minimizing challenges and maximizing rewards among very old parents and their children. Focusing on relationship perceptions of the child may be particularly critical in improving the experiences of both parent and child.
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THE ROLE OF RELATIONSHIP FACTORS IN HARMFUL CAREGIVER BEHAVIORS: OLDER CHILDREN CARING FOR PARENTS WITH DEMENTIA. Innov Aging 2022. [PMCID: PMC9766676 DOI: 10.1093/geroni/igac059.2291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Elder abuse by family caregivers is an often-overlooked phenomenon that affects many older adults. Especially, retirement-aged children caring for their oldest-old parents with dementia may be at greater risk of engaging in harmful or abusive behaviors, given their own age-related health issues and other competing caregiving demands. Most of the elder abuse literature has focused on general demographic predictors of elder abuse, regarding the caregiver, care recipient, and the care environment. Less attention has been paid towards relationship factors, which may play a large role among these parent-child dyads. This study examined how relationship factors are associated with potentially harmful caregiver behaviors (PHCB; e.g., screaming), which have been identified as “early warning signs” for elder abuse. Relationship factors of interest include positive and negative relationship quality measured by caregivers’ mean scores on the support and conflict subscales on the Quality of Relationship Inventory (QRI). We conducted in-depth interviews with 88 caregivers (65+) who are caring for their parents with dementia (90+) as the part of the Boston Aging Together Study. Regression models revealed that relationship conflict was significantly associated with higher levels of PHCB, accounting for caregiver, care recipient, and care environment characteristics. The creation of screeners to identify “high conflict” care dyads could prove useful in the early detection and intervention of potential elder abuse cases, given that caregivers may be more willing to report negative aspects of their relationship (e.g., fighting) than more obviously harmful or abusive behaviors.
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179 WHAT IS THE RISK OF FALLS DUE TO PSYCHOTROPIC MEDICATIONS IN A LARGE POPULATION-REPRESENTATIVE COHORT OF COMMUNITY-DWELLING OLDER PEOPLE? Age Ageing 2022. [DOI: 10.1093/ageing/afac218.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Psychotropic medications including antidepressants, anticholinergics, benzodiazepines, ‘Z’ drugs and antipsychotics, are frequently identified as Falls Risk Increasing Drugs (FRIDS), yet there is a relative lack of robust data detailing the prospective risk of falls associated with these drug classes.
Methods
Participants aged ≥65 years from the Irish Longitudinal Study on Ageing (TILDA) were included and followed from Waves 1 to 5 (Mean 7.6 years follow-up). Incidence of falls was ascertained by self-report and unexplained falls were defined as falls not caused by a slip or trip with no apparent cause. Medication lists were examined for medications of interest. Logistic Regression models, reporting odds ratio with 95% confidence intervals, were used to assess the association between medication classes and incident fall types and were adjusted for relevant covariates.
Results
2,090 participants were included (mean age at baseline 72 years, 53% female). During follow-up, over half of participants (52%, n=1,089) had a fall, with one quarter (25%, n=526) reporting an unexplained fall and almost one fifth (19%, n=394) reporting a fall causing injury. Anti-depressants were associated with an increased risk of falling (OR=3.01, 1.98-4.58, p<0.001), injurious falls (OR=1.96, 1.37-2.81, p<0.001) and unexplained falls (OR=2.71, 1.88-3.91, p<0.001) in fully adjusted models. Anti-cholinergic medications were associated with an increased risk of falling (OR=1.79, 1.11-2.88, p=0.017) and of unexplained falls (OR=1.89, 1.19-3.01, p=0.007). ‘Z’ drugs were associated with an increased risk of falling (OR=2.96, 1.64-5.32, p<0.001) and of injurious falls (OR=2.05, 1.26-3.34, p=0.004). Benzodiazepines and Anti-psychotics were not associated with incident falls in fully adjusted models.
Conclusion
Anti-depressants, anti-cholinergic medications and ‘Z’ drugs are independently associated with an increased falls risk. Given the profound impact falls can have on functional trajectory and quality of life, regular review of ongoing need for these medications should be central to the comprehensive geriatric assessment.
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Adult North Star Network (ANSN): Consensus Document for Therapists Working with Adults with Duchenne Muscular Dystrophy (DMD) - Therapy Guidelines. J Neuromuscul Dis 2022; 9:365-381. [PMID: 35124658 DOI: 10.3233/jnd-210707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Challenges for Children 65+ Caring for Parents 90+ With Dementia During COVID-19. Innov Aging 2021. [PMCID: PMC8682704 DOI: 10.1093/geroni/igab046.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
With the rise of the novel coronavirus, family caregivers of persons with dementia have been tasked with adapting to an entirely new caregiving landscape. Adult children caring for parents in the ‘oldest old’ age group bear an additional burden. Namely, children that are older adults themselves are navigating the joint vulnerability of both their own and their parents’ aging-related issues (e.g., health problems). The aim of this study was to explore the experiences of dementia caregivers during COVID-19 from the unique perspective of children aged 65 and older caring for parents aged 90 and older. Participants were 30 caregivers from the Boston Aging Together Study with whom we conducted in-depth interviews between March 2020 and February 2021. Thematic analysis revealed key challenges related to COVID-19. Children were worried about the prospect of their parent contracting the virus and took steps to minimize their parent’s exposure, such as discontinuing use of formal supports (e.g., home health aides) or assistance from other family and friends. Forgoing these supports often created greater responsibilities for caregivers as well as contributed to greater social isolation for both child and parent. In situations where parents resided in institutional settings, children were often unable to provide necessary help and support to parents due to restrictions. Caregivers also faced difficulties due to their parent not understanding or practicing COVID-19 regulations and in utilizing alternative means of communication with their parent (e.g., video conferencing). Supports and services should be designed in light of the unique challenges of this group.
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“I’m Getting Older Too”: Challenges and Benefits Experienced by Very Old Parents and Their Children. Innov Aging 2021. [PMCID: PMC8970015 DOI: 10.1093/geroni/igab046.2781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Very old parents and their “old” children are a growing group in industrialized countries worldwide. Since most very old persons have outlived spouses and friends, their children, many of whom have reached old age themselves, are likely to become their primary social contact and to shoulder the care provision role. However, virtually nothing is known about the nature and implications of this relationship constellation. To fill this gap, the present study explored the challenges and rewards of the very old parent-child relationship. In-depth interviews were conducted with 114 parent-child dyads (parent age ≥ 90; child age ≥ 65). Narrative interview data on challenges and rewards were audiotaped, transcribed, and then systematically reviewed and coded, identifying recurrent themes and defining categories that reflected these themes. While both challenges and rewards were present, more rewards than challenges were reported overall. However, comparing parent and child perspectives revealed that the balance of challenges and rewards was less favorable for children. Narrative data further showed that the sense of burdening their children heavily weighed on at least a fourth of parents, reflecting this as a serious concern not only for children but also for parents. Challenges reported by children were often characterized by references to children’s own advanced age and health problems, and the prolonged caregiving involvement due to their parents’ longevity. Healthcare professionals, policy makers, and families should be made aware of this increasingly common phenomenon, and specific services and policies will be needed to adequately support very old adults and their families.
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181 FIGHTING BACK AGAINST FRAILTY—THE INTRODUCTION OF A DEDICATED FRAILTY HUB. Age Ageing 2021. [PMCID: PMC8690016 DOI: 10.1093/ageing/afab219.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Quarantine, lockdowns and mandatory isolation have slowed the transmission of Covid-19. However, these public health measures have amplified frailty in our vulnerable older person population by increasing social disconnection, reducing exercise and access to early interventions. In response to this increasingly dependent older population we introduced a ‘frailty hub’ in our hospital. This hub allowed early access to a geriatric review as well as a broader multidisciplinary team intervention. Methods We performed a cross sectional review of our new hub which was introduced in our tertiary centre to priortise care of the older person.We analysed attendees from February to June 2021 (20 weeks of data). Results There were 121 new patient reviews and 127 follow up consultations.Commonly requested reason for referral was medical assessment (30%), cognitive assessments (30%) and falls(28%). Referral sources were analysed and included consultant referrals (11% n = 13), GP referrals (55% n = 67), multidisciplinary team referrals (6% n = 7) and emergency department referrals (26% n = 32). The average age of those review was 79 years (range 59 years to 99 years). Of all patients 65% were reviewed by physiotherapist, 45% were seen by an occupational therapist, 10% were seen by a speech and language therapist or dietician. 85% had a medication changes. 95% had a follow up review with either a geriatrician or advanced nurse practitioner. Conclusion Innovation is required to appropriately target our most vulnerable frail adults.The pandemic has had a detrimental effect on some older adult’s function.Our hub is targeting this group and optimising their care.These are our preliminary findings, we plan on doing further analysis.
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425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways. Open Forum Infect Dis 2020. [PMCID: PMC7776659 DOI: 10.1093/ofid/ofaa439.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The Centers for Disease Control and Prevention (CDC) recommends upper respiratory tract (URT) polymerase chain reaction (PCR) testing as the initial diagnostic test for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Lower respiratory tract (LRT) testing for patients requiring mechanical ventilation is also recommended. The goal of this study was to evaluate concordance between paired URT and LRT specimens in children undergoing pre-admission/procedure screening or diagnostic testing. We hypothesized that < 10% of paired tests would have discordant results. Methods Single center cross-sectional study including children with artificial airways who had paired URT and LRT SARS-CoV-2 PCR testing between 4/1/2020 and 6/8/2020. URT specimens included nasopharyngeal (NP) swabs and aspirates. LRT specimens included tracheal aspirates and bronchoalveolar lavages. URT and LRT specimens were classified as paired if the two specimens were collected within 24 hours. Artificial airways included tracheostomies and endotracheal tubes. Tests were classified as diagnostic versus screening based on the indication selected in the order. Results 102 paired specimens were obtained during the study period. Fifty-nine were performed for screening and 43 were performed for diagnosis of suspected SARS-CoV-2. Overall, 94 specimens (92%) were concordant, including 89 negative from both sources and 5 positive from both sources. Eight specimens (8%) were discordant, all of which were positive from the URT and negative from the LRT (Figure 1). Among patients undergoing screening, 3 of 4 positive tests were discordant and among symptomatic patients, 5 of 9 positive tests were discordant. There were no instances of a positive LRT specimen with a negative URT specimen. Figure 1. Performance of upper and lower respiratory tract SARS-CoV-2 PCR testing in children with artificial airways ![]()
Conclusion Overall, most paired samples from the URT and LRT yielded concordant results with no pairs positive from the LRT and negative from the URT. These data support the CDC recommendation that URT specimens are the preferred initial SARS-CoV-2 test, while LRT specimens should be collected only from mechanically ventilated with suspected SARS-CoV-2. Disclosures All Authors: No reported disclosures
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Cognitive Functioning, Gender, and Marital Quality Among Older Married Couples: A Dyadic Approach. Innov Aging 2020. [PMCID: PMC7742678 DOI: 10.1093/geroni/igaa057.2042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Older spouses influence one another in myriad ways, and dyadic effects of marital quality on health and well-being have been well-established. However, little attention has been paid to dyadic implications of cognitive functioning, including for spouses’ perceptions of the relationship itself. This study examines associations of older husbands’ and wives’ cognitive functioning with both partners’ reports of four marital quality outcomes. Structural equation modeling analyzed data from 1,414 opposite-sex couples drawn from the 2016 wave of the Health and Retirement Study. Findings revealed that (a) wives’ poorer cognitive functioning was associated with wives’ reporting greater closeness and higher ratings of enjoying time with a spouse, whereas (b) husbands’ poorer cognitive functioning was associated with wives’ reporting greater marital strain, lower marital support, lower closeness, and lower ratings of enjoying time with a spouse. This suggests that cognitive functioning/impairment has dyadic consequences for marital quality, which are highly gendered.
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Characterising the sensory quality and volatile aroma profile of clean-label sucrose reduced sponge cakes. Food Chem 2020; 342:128124. [PMID: 33127226 DOI: 10.1016/j.foodchem.2020.128124] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/19/2020] [Accepted: 09/14/2020] [Indexed: 12/14/2022]
Abstract
The sensory and aroma quality of 30% (w/w) sucrose reduced sponge cakes incorporating clean-label replacers were investigated. The sensory quality of the reformulated sponge cakes varied, with those containing apple pomace powder (APP) showing the greatest difference to the control (SC100). Volatile profiles mainly differed in relation to compounds derived from the Maillard reaction, caramelisation and lipid oxidation. Thrity six aroma active volatile compounds were identified in the SC100, APP and oligofructose (OLIGO) sponge cakes by olfactometry. Furfural 'spicy bready' contributed most to the overall aroma of all samples, with factor dilution values differing the most for heptanal 'fatty cake crust', methional 'potato damp', and 2,5-dimethylpyrazine 'cake crust, nutty'. This study provides an in-depth insight into the impact of sugar reduction reformulation on the sensory perception of sponge cakes and demonstrates how this approach can be used to improve the sensory perception of reduced sucrose sponge cakes.
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PIN31 The Epidemiology and Cost of Dengue Disease in Thailand: A Systematic Literature Review. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Objective: Spousal caregiving is increasingly common, and it is a role that can alter the nature of marriage in later life. Some may find spousal caregiving to be distressing, while others may have more positive experiences. Spousal caregiving, in particular, may be difficult due to caregiver burden as well as a loss of couplehood within the relationship. The current study used grounded theory methods to better understand the experience of and changes in couplehood among spousal caregivers.Method: Thirteen spousal caregivers completed semi-structured interviews. Spousal caregivers ranged in age from 53 to 85 (mean age = 66.00, SD = 9.04).Results: Qualitative analysis revealed four major themes upon evaluation of the interviews (couplehood, positive mindset, later life roles and transitions, and looking towards the future).Conclusion: These themes exemplified the complex interplay of couplehood and caregiving as well as the range of perceptions of couplehood. Results showed that while some caregivers struggle to find meaning and happiness within their caregiver role, and others said the illness/impairment bonded them together. Caregivers who reported a low sense couplehood discussed feeling trapped in their relationship, sad, and isolated. For some caregivers, a strong sense of couplehood may have helped them reframe the experience as an opportunity to be a role model for others and a reminder that their situation could be worse. Future research should focus on pre-illness couplehood and whether the nature of the impairment (e.g., cognitive, physical) is related to caregiver's couplehood.
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Buffer or Blade: Perceived relationship closeness in couples navigating Alzheimer's. J Aging Stud 2020; 52:100832. [DOI: 10.1016/j.jaging.2020.100832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/28/2019] [Accepted: 01/03/2020] [Indexed: 11/29/2022]
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Abstract
Forager mobility tends to be high, although ethnographic studies indicate ecological factors such as resource abundance and reliability, population density and effective temperature influence the cost-to-benefit assessment of movement decisions. We investigate the evolution of mobility using an agent-based and spatially explicit cultural evolutionary model that considers the feedback between foragers and their environment. We introduce Outcomes Clustering, an approach to categorizing simulated system states arising from complex stochastic processes shaped by multiple interacting parameters. We find that decreased mobility evolves under conditions of high resource replenishment and low resource depletion, with a concomitant trend of increased population density and, counter-intuitively, decreased food incomes. Conversely, increased mobility co-occurs with lower population densities and higher food incomes. We replicate the well-known relationships between mobility, population density, and resource quality, while predicting reduced food income, and consequently the reduction in health status observed in early sedentary populations without the need to invoke factors such as reduced diet quality or increased pathogen loads.
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‘TAKING IT ONE DAY AT A TIME’: COUPLES NAVIGATING EARLY ALZHEIMER’S. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Depression and anxiety symptoms during the transition to early adulthood for people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:407-421. [PMID: 29473259 DOI: 10.1111/jir.12478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 12/12/2017] [Accepted: 01/18/2018] [Indexed: 05/07/2023]
Abstract
BACKGROUND The transition to adulthood is a major developmental milestone; a time of self-discovery and increased independence. For young adults (YA) with intellectual disabilities (ID), however, this period is especially challenging. The increased incidence of mental health disorders in this population, such as depression and anxiety, make this transition even more difficult, increasing caregiver burden at a time when the young adult would traditionally be gaining independence. It is not clear, however, why YA with ID are more susceptible and what factors may predict mental health symptoms. METHOD Potential risk and protective factors (demographic variables, coping styles, sense of hopelessness, unmet achievement of adulthood milestones, self-reflection and insight) of anxiety and depression symptoms were assessed in 55 YA with ID and a sample of age-matched controls. RESULTS Insight was the strongest predictor of anxiety (with gender in the controls) for YA with and without ID, with increased insight predicting fewer anxiety symptoms. However, YA with ID had significantly less insight than their aged-matched counterparts and significantly higher levels of anxiety. They were also less likely to have achieved traditional adulthood milestones. Maladaptive coping was the strongest predictor of depression for YA with ID. In comparison, both maladaptive coping and insight predicted depression in controls. More maladaptive coping predicted increased depressive symptoms in both populations, whilst increased insight predicted fewer depressive symptoms in controls. CONCLUSIONS Insight and maladaptive coping are potential targets in the treatment of anxiety and depression among YA with ID. Longitudinal intervention studies exploring the efficacy of such targeted programmes in reducing mental health symptoms and improving the transition to adulthood for these young people are recommended.
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Developing indicators for evaluation of age-friendly communities in Canada: process and results. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2017; 36:214-223. [PMID: 27768558 DOI: 10.24095/hpcdp.36.10.02] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION In 2006, the World Health Organization launched the Global Age-Friendly Cities Project to support active aging. Canada has a large number of age-friendly initiatives; however, little is known about the effectiveness and outcomes of age-friendly community (AFC) initiatives. In addition, stakeholders report that they lack the capacity and tools to develop and conduct evaluations of their AFC initiatives. In order to address these gaps, the Public Health Agency of Canada developed indicators to support the evaluation of AFC initiatives relevant to a wide range of Canadian communities. These indicators meet the varied needs of communities, but are not designed to evaluate collective impact or enable crosscommunity comparisons. METHODS An evidence-based, iterative consultation approach was used to develop indicators for AFCs. This involved a literature review and an environmental scan. Two rounds of key expert and stakeholder consultations were conducted to rate potential indicators according to their importance, actionability and feasibility. A final list of indicators and potential measures were developed based on results from these consultations, as well as key policy considerations. RESULTS Thirty-nine indicators emerged across eight AFC domains plus four indicators related to long-term health and social outcomes. All meet the intended purpose of evaluating AFC initiatives at the community level. A user-friendly guide is available to support and share this work. CONCLUSION The AFC indicators can help communities evaluate age-friendly initiatives, which is the final step in completing a cycle of the Pan-Canadian AFC milestones. Communities are encouraged to use the evaluation results to improve their AFC initiatives, thereby benefiting a broad range of Canadians.
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Bilateral Frostbite of the Hands. EPLASTY 2015; 15:ic37. [PMID: 26191335 PMCID: PMC4502637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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A RING to rule them all? Insights into the Map3k1 PHD motif provide a new mechanistic understanding into the diverse roles of Map3k1. Cell Death Differ 2015; 22:540-8. [PMID: 25613373 PMCID: PMC4356348 DOI: 10.1038/cdd.2014.239] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 12/15/2014] [Accepted: 12/17/2014] [Indexed: 12/26/2022] Open
Abstract
Despite the sizable number of components that comprise Mapk cascades, Map3k1 is the only element that contains both a kinase domain and a plant homeodomain (PHD) motif, allowing Map3k1 to regulate the protein phosphorylation and ubiquitin proteasome systems. As such, Map3k1 has complex roles in the regulation of cell death, survival, migration and differentiation. Numerous mouse and human genetic analyses have demonstrated that Map3k1 is of critical importance for the immune system, cardiac tissue, testis, wound healing, tumorigenesis and cancer. Recent gene knockin of Map3k1 to mutate the E2 binding site within the Map3k1 PHD motif and high throughput ubiquitin protein array screening for Map3k1 PHD motif substrates provide critical novel insights into Map3k1 PHD motif signal transduction and bring a brand-new understanding to Map3k1 signaling in mammalian biology.
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Costs Associated with the Use of Enzyme-Inducing Anti-Epileptic Drugs Versus Non-Enzyme-Inducing Anti-Epileptic Drugs: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A394-A395. [PMID: 27200921 DOI: 10.1016/j.jval.2014.08.879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Enhancing an Extruded Puffed Snack by Optimising Die Head Temperature, Screw Speed and Apple Pomace Inclusion. FOOD BIOPROCESS TECH 2013. [DOI: 10.1007/s11947-013-1181-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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24
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Bacterial and fungal community composition over time in chicken litter with high or low moisture content. Br Poult Sci 2013; 53:561-9. [PMID: 23281748 DOI: 10.1080/00071668.2012.723802] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
1. Changes in bacterial and fungal communities in chicken litter with high and low moisture content over a five week period during a single chicken grow out cycle in a poultry shed in subtropical Australia were investigated to study the association between specific microbes and odour production. 2. Microbial biomass, as indicated by DNA yields, was higher and community composition was more dynamic over time in moist compared with dry chicken litter. 3. Bacillus, Atopostipes and Aspergillus species increased in relative abundance in moist chicken litter samples over time reflecting the relatively high fitness and hence activity of these specific bacteria and this specific fungus in this environment.
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P225 Routes of Domiciliary Non-Invasive Ventilation (NIV) Set-Up. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstracts of the 27th Patient Classification Systems International (PCSI) Working Conference. Montreal, Canada. October 19-22, 2011. BMC Health Serv Res 2011; 11 Suppl 1:A1-25. [PMID: 22151842 PMCID: PMC3238184 DOI: 10.1186/1472-6963-11-s1-a1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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P267 Association of the length of non-invasive ventilation (NIV) with arterial bicarbonate level in COPD patients with acute hypercapnic respiratory failure (AHRF). Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dough characteristics of Irish wheat varieties II. Aeration profile and baking quality. Lebensm Wiss Technol 2011. [DOI: 10.1016/j.lwt.2010.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dough characteristics of Irish wheat varieties I. Rheological properties and prediction of baking volume. Lebensm Wiss Technol 2011. [DOI: 10.1016/j.lwt.2010.11.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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31
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National identity and in-group/out-group attitudes: Catholic and Protestant children in Northern Ireland. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2011. [DOI: 10.1080/17405629.2010.533977] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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P158 The strength of association between the risk of endotracheal intubation and initial arterial blood (ABG) pH in patients presenting with acute hypercapnic respiratory failure (AHRF) treated with non-invasive ventilation (NIV). Thorax 2010. [DOI: 10.1136/thx.2010.151043.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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S70 Non-invasive ventilation (NIV) in Chronic Obstructive Pulmonary Disease (COPD) exacerbations with acute hypercapnic respiratory failure (AHRF) with pH. Thorax 2010. [DOI: 10.1136/thx.2010.150938.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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P155 Non-invasive ventilation (NIV) in acute hypercapnic respiratory failure in restrictive lung diseases (RLD). Thorax 2010. [DOI: 10.1136/thx.2010.151043.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Taking notice of observation service opportunities and risks. REVENUE-CYCLE STRATEGIST 2010; 7:5. [PMID: 21268550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Nutritive value and chemical composition of pseudocereals as gluten-free ingredients. Int J Food Sci Nutr 2010; 60 Suppl 4:240-57. [PMID: 19462323 DOI: 10.1080/09637480902950597] [Citation(s) in RCA: 160] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The only treatment available for patients with coeliac disease is a lifelong elimination of food products containing gluten. The gluten-free products currently available in the market are considered of low quality and poor nutritional value. In the present study, the pseudocereals amaranth, quinoa and buckwheat were studied as potential healthy ingredients for improving the nutritional quality of gluten-free breads. The pseudocereal seeds and pseudocereal-containing gluten-free breads were evaluated in terms of their protein, fat, total starch, dietary fibre, ash and mineral content as well as their fatty acid composition. The pseudocereal containing gluten-free breads showed significantly higher levels of protein, fat, fibre and minerals than the control bread. The attributes of these breads conform to the expert's nutritional recommendations for the gluten-free diet and gluten-free foods. These results suggest that the pseudocereals amaranth, quinoa and buckwheat can represent a healthy alternative to frequently used ingredients in gluten-free products.
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Depression and EGFR mutation status in stage IV non-small cell lung cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Effect of early palliative care (PC) on quality of life (QOL), aggressive care at the end-of-life (EOL), and survival in stage IV NSCLC patients: Results of a phase III randomized trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7509] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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40
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Rheological properties and baking quality of wheat varieties from various geographical regions. J Cereal Sci 2010. [DOI: 10.1016/j.jcs.2010.02.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nutritive value of pseudocereals and their increasing use as functional gluten-free ingredients. Trends Food Sci Technol 2010. [DOI: 10.1016/j.tifs.2009.10.014] [Citation(s) in RCA: 364] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Ribonucleic acid interference (RNAi) has become an effective tool for studying gene function in a variety of cells. The objective of this study was to compare the efficiency of gene silencing when siRNA were introduced into bovine zygotes by microinjection (as done previously; Tesfaye D et al. 2007 Mol. Reprod. Dev. 74, 978-988) v. a novel method of transfection in terms of gene knockdown and embryo development. For microin-jection, in vitro-produced bovine zygotes (16 h post insemination) were randomly assigned to 1 of 3 groups over 2 experiments. In Experiment 1, E-cadherin siRNA was injected at 100 μM (n = 168) and compared with PBS-injected (n = 180) and noninjected controls (n = 152). In Experiment 2, E-cadherin siRNA was injected at 375 μM (n = 154) and compared with PBS-injected (n = 136) and noninjected controls (n = 151). Embryos were subsequently cultured in vitro until Day 7 (day of IVF = Day 0). For transfection, the zona pellucida was removed from in vitro-produced zygotes. Zona-free zygotes were randomly assigned to 1 of 4 groups (i) GAPDH (n = 67), (ii) scrambled (n = 66), (iii) E-cadherin (n = 69) siRNA treatments at 100 nM or (iv) nontransfected controls (n = 66). Zygotes were incubated in transfection medium with siRNA for 1 h at 39°C, cultured individually in the well-of-the-well system to Day 7. The proportion of zygotes undergoing cleavage and developing to the blastocyst stage was recorded, and Day 7 embryos were frozen individually for mRNA analysis. Data for mRNA expression were fitted to a general linear model, and developmental stages were tested using ANOVA. Microinjection of 100 μM E-cadherin siRNA had no effect on phenotype (P > 0.05). Injection of PBS or 375 μM E-cadherin siRNA resulted in a decrease in the number of embryos reaching the 8-cell stage (51.5%, 45.5%, and 62.9%, respectively) and blastocyst stage (39.0%, 32.5%, and 45%, respectively) compared with noninjected controls (P < 0.05). The mRNA abundance of the target gene was suppressed by 36 and 46% when siRNA targeting E-cadherin was injected at 100 μM and 375 μM compared with control and PBS-injected groups (P < 0.05). Transfection with E-cadherin siRNA decreased development of 8-cell embryos (20.3 v. 53.0%, respectively) and blastocysts (7.2 v. 18.2%, respectively) compared with controls (P < 0.05). The mRNA relative abundance was not different between controls (nontransfected, or transfected with GAPDH or scrambled siRNA). However, transfection of zygotes with 100nM E-cadherin siRNA led to a 70% reduction in E-cadherin mRNA relative abundance in Day 7 blastocysts compared with controls (P < 0.05). Zona removal and transfection resulted in decreased embryo development compared with microinjection (P < 0.05). However, transfection yielded more efficient gene silencing of E-cadherin mRNA with reduced embryo development compared with microinjection. This technique of gene silencing could improve the efficiency of gene function studies in early bovine embryogenesis.
Supported by Science Foundation Ireland.
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285 RELATIONSHIP BETWEEN FOLLICLE FLUID STEROID CONCENTRATIONS, GRANULOSA CELL GENE EXPRESSION, AND BOVINE OOCYTE DEVELOPMENTAL COMPETENCE. Reprod Fertil Dev 2010. [DOI: 10.1071/rdv22n1ab285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The ability to culture oocytes and embryos in an individually identifiable manner facilitates the study of the relationship between follicle param- eters and oocyte development, in order to identify markers of competent oocytes. The aim of this study was to examine the predictive value of intrafollicular steroid concentrations and granulosa cell transcript abundance on the ability of immature bovine oocytes to develop to the blastocyst stage in vitro. Individual follicles (n = 214, 11 replicates, 49 animals) were dissected from the ovaries of slaughtered animals. Following measure- ment of diameter, follicles were carefully ruptured under a stereomicroscope and the oocyte was recovered and individually processed through maturation, fertilization, and culture on the cell adhesive Cell-Tak (20 oocytes/100 μL; Matoba and Lonergan 2009 Reprod. Fertil. Dev. 21, 160). Cleavage and blastocyst rates were assessed on Days 2 and 9, respectively. Follicular fluid was recovered and stored at -80°C until analysis for concentrations of the steroids estradiol, progesterone, and testosterone by RIA. Granulosa cells were collected from each follicle for analysis of gene expression by quantitative RT-PCR. Primers were designed for 7 target genes (AMH, CYP19A, ESR1, ESR2, FSHR, HSD3B1 and LHCGR) and 2 reference genes (PPIA and H2AZ). Transcript abundance of target genes in granulosa cells associated with embryos that cleaved and developed to the blastocyst stage (competent) and those that cleaved but failed to develop (incompetent) was examined. Mean steroid concentrations were compared by ANOVA and Spearman correlations, and logistical regression were used to test the relationship between follicle size and steroid con- centration and the ability of steroid concentration to predict developmental competence. Gene expression data were analyzed using the delta-delta CT (cycle threshold) method. Values were normalized to the average values of the reference genes and means were compared by the Student’s t-test In total, 79.1% of oocytes cleaved after IVF and 28.3% developed to the blastocyst stage. The mean (±SEM) follicular concentrations of testosterone (62.8 ± 4.8 ng mL-1), progesterone (616.8 ± 31.9 ng mL-1), or estradiol (14.4 ± 2.4 ng mL-1 were not different (P ≥ 0.05) between competent and incompetent oocytes. Follicular diameter was negatively correlated with testosterone, progesterone, testosterone:estradiol, and pro- gesterone:estradiol (P ≤ 0.01) and positively correlated with estradiol (P ≤ 0.01). Logistical regression analysis showed that steroid concentrations or the ratio of steroids were not satisfactory predictors of oocyte competence. Transcript abundance of AMH, ESR1, ESR2, FSHR, and HSD3B1 was significantly higher (P ≤ 0.05) in granulosa cells associated with competent compared with incompetent oocytes. In conclusion, follicular steroid concentrations were not associated with oocyte development. In contrast, granulosa cell gene expression may be a useful predictor of oocyte competence.
Supported by Science Foundation Ireland (07/SRC/B1156).
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Smooth operators. Nurs Manag (Harrow) 2009; 40:40-43. [PMID: 19901756 DOI: 10.1097/01.numa.0000363869.15822.af] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Comparison of odour emission rates measured from various sources using two sampling devices. BIORESOURCE TECHNOLOGY 2009; 100:118-124. [PMID: 18625551 DOI: 10.1016/j.biortech.2008.05.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 05/25/2008] [Accepted: 05/27/2008] [Indexed: 05/26/2023]
Abstract
Two commonly used sampling devices (a wind tunnel and the US EPA dynamic emission chamber), were used to collect paired samples of odorous air from a number of agricultural odour sources. The odour samples were assessed using triangular, forced-choice dynamic olfactometry. The odour concentration data was combined with the flushing rate data to calculate odour emission rates for both devices on all sources. Odour concentrations were consistently higher in samples collected with a flux chamber (ratio ranging from 10:7 to 5:1, relative to wind tunnel samples), whereas odour emission rates were consistently larger when derived from wind tunnels (ratio ranging from 60:1 to 240:1, relative to flux chamber values). A complex relationship existed between emission rate estimates derived from each device, apparently influenced by the nature of the emitting surface. These results have great significance for users of odour dispersion models, for which an odour emission rate is a key input parameter.
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118: Metoclopramide in the Emergency Department: A Randomized Factorial Design Study to Determine the Influence of Dose and Diphenhydramine on Akathisia. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Long-term assessment of efficacy of permeable pond covers for odour reduction. BIORESOURCE TECHNOLOGY 2008; 99:6409-6418. [PMID: 18248811 DOI: 10.1016/j.biortech.2007.11.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2006] [Revised: 11/21/2007] [Accepted: 11/21/2007] [Indexed: 05/25/2023]
Abstract
Three anaerobic ponds used to store and treat piggery wastes were fully covered with permeable materials manufactured from polypropylene geofabric, polyethylene shade cloth and supported straw. The covers were assessed in terms of efficacy in reducing odour emission rates over a 40-month period. Odour samples were collected from the surface of the covers, the surface of the exposed liquor and from the surface of an uncovered (control) pond at one of the piggeries. Relative to the emission rate of the exposed liquor at each pond, the polypropylene, shade cloth and straw covers reduced average emission rates by 76%, 69% and 66%, respectively. At the piggery with an uncovered control pond, the polypropylene covers reduced average odour emission rates by 50% and 41%, respectively. A plausible hypothesis, consistent with likely mechanisms for the odour reduction and the olfactometric method used to quantifying the efficacy of the covers, is offered.
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