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To examine the strengths and opportunities for improvement of current home care education practices to inform the development of the Home Care for Heart Health intervention, and to develop a web-based intervention for parents and clinicians with complimentary print materials that could provide the right education at the right time to foster a safer transition from hospital to home.
An inter-professional focus group of parents, clinicians, and designers was formed to co-create a home care education intervention for parents of children with congenital heart disease (CHD) and their care team. We used the Integrated New Product Development process model created by Jonathon Cagan and Craig Vogel at Carnegie Mellon University to develop the intervention. This process model is a way of thinking that combines horizontal and inter-disciplinary teams, stakeholder-centric focus, and a system of qualitative discovery and development evolving towards quantitative methods of refinement.
Our team developed the Home Care for Heart Health intervention. The evidenced-based intervention includes a quick reference guide for parents of children with CHD, an accompanying app, family-friendly pathways, and clinician education.
Using an inter-professional approach, our team of clinicians, parents, and design experts were able to co-create a clinician–parent home care education intervention with broad application and lifelong relevance to the Congenital Heart Disease Community.
Our intervention has the potential to be used as a model for other home care education interventions for parents of children with chronic illnesses.
Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression.
We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol.
We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47–2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04–1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94–1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81–1.32).
Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.
This paper briefly describes the principle of operation and science goals of the AMANDA high energy neutrino telescope located at the South Pole, Antarctica. Results from an earlier phase of the telescope, called AMANDA-BIO, demonstrate both reliable operation and the broad astrophysical reach of this device, which includes searches for a variety of sources of ultrahigh energy neutrinos: generic point sources, Gamma-Ray Bursts and diffuse sources. The predicted sensitivity and angular resolution of the telescope were confirmed by studies of atmospheric muon and neutrino backgrounds. We also report on the status of the analysis from AMANDA-II, a larger version with far greater capabilities. At this stage of analysis, details of the ice properties and other systematic uncertainties of the AMANDA-II telescope are under study, but we have made progress toward critical science objectives. In particular, we present the first preliminary flux limits from AMANDA-II on the search for continuous emission from astrophysical point sources, and report on the search for correlated neutrino emission from Gamma Ray Bursts detected by BATSE before decommissioning in May 2000. During the next two years, we expect to exploit the full potential of AMANDA-II with the installation of a new data acquisition system that records full waveforms from the in-ice optical sensors.
Physical inactivity and low birth weight (LBW) may lead to an increased risk for developing type 2 diabetes. The extent to which LBW individuals may benefit from physical exercise training when compared with those with normal birth weight (NBW) controls is uncertain. We assessed the impact of an outdoor exercise intervention on body composition, insulin secretion and action in young men born with LBW and NBW in rural India. A total of 61 LBW and 56 NBW healthy young men were recruited into the study. The individuals were instructed to perform outdoor bicycle exercise training for 45 min every day. Fasting blood samples, intravenous glucose tolerance tests and bioimpedance body composition assessment were carried out. Physical activity was measured using combined accelerometry and heart rate monitoring during the first and the last week of the intervention. Following the exercise intervention, the LBW group displayed an increase in physical fitness [55.0 ml (O2)/kg min (52.0−58.0)−57.5 ml (O2)/kg min (54.4−60.5)] level and total fat-free mass [10.9% (8.0−13.4)−11.4% (8.0−14.6)], as well as a corresponding decline in the ratio of total fat mass/fat-free mass. In contrast, an increase in total fat percentage as well as total fat mass was observed in the NBW group. After intervention, fasting plasma insulin levels, homoeostasis model assessments (HOMA) of insulin resistance (HOMA-IR) and insulin secretion (HOMA-IS), improved to the same extent in both the groups. In summary, young men born with LBW in rural India benefit metabolically from exercise training to an extent comparable with NBW controls.
Acquired resistance against Ascaridia galli infection was studied in seventy-two 18-week-old white Leghorn chickens allocated to six groups (G1–G6). In order to understand the population dynamics following trickle-infection (100 eggs per chicken twice weekly), chickens of subgroups of G1 were necropsied 3 days after 1, 6 or 12 inoculations (G1A, G1B and G1C respectively), while G2–G4 were inoculated for 6 weeks. G2 was necropsied 4 weeks after the last inoculation. The number of established larvae increased initially (between G1A and G1B) but decreased after repeated inoculations (G1C, G2). G3, G4 and G5 were used to measure the efficacy of anthelminthic treatment and to monitor the acquisition of resistance following a challenge infection. At week 7 G3, G4 and G5 were treated with flubendazole for 7 days in the feed. Two weeks after treatment the chickens in G4 and G5 were challenged with 500 eggs. G6 was left as uninfected control. Necropsy at week 10 after first inoculation revealed a lower establishment rate, an impaired development and a more posterior localization of the larvae in G4 (trickle-infected-treated-challenged) compared with G5 (treated-challenged). IgY level in serum reached noticeable level at 14 dpi in G2 and G4 chickens, and in G4 chickens IgY level further increased after challenge infection. The study provides evidence that acquired resistance against A. galli in chickens leads to a significant yet incomplete protection against re-infection.
Doping process windows are becoming very narrow as VLSI technology nodes scale to smaller and smaller dimensions. The time and cost required to develop new doping methods and the desire to re-use equipment will make it likely that current methods will be applied as long as possible. This means that existing process tools will have very tight stability and uniformity requirements, and metrology will be required to drive process control. The paper describes the state-of-the-art of both doping processes involving ion implantation and spike annealing, and new metrology based on Carrier IlluminationTM methods that will be required to implement in-line process control for these processes. CI offers depth resolution on the order of1Å, providing a level of control required to extend existing doping methods. The prospects of new methods such as Laser Thermal Annealing (LTA) are also discussed.
(2-Methoxy)ethoxy substituted anilines have been polymerized by chemical and electrochemical methods in hydrochloric acid (HC1) and p-toluenesulphonic acid(TsOH). Electrical conductivity, optical properties, solubility and charge capacity of these polymers are discussed.
Thin films of CeO2 deposited by rf magnetron sputtering on sapphire and silicon substrates have been characterized with variable angle spectroscopie ellipsometry, atomic force microscopy (AFM), transmission electron microscopy and x-ray diffraction. A novel multiple model was used successfully for determination of the optical properties and surface roughness of the CeO2films. AFM analysis showed that the CeO2 films have hillock-shaped facet morphology. It was found that the surface roughness of CeO2 increased with film thickness. For films on sapphire substrates, the surface morphology and the crystalline quality were improved by post-annealing, e.g. flat surfaces were obtained after annealing at 1100 °C.
The objective of this study was to estimate heritabilities for and genetic correlations among different pathogen-specific mastitis traits. The traits were unspecific mastitis, which is all mastitis treatments regardless of the causative pathogen as well as mastitis caused by Streptococcus dysgalactiae, Escherichia coli, coagulase-negative staphylococci (CNS), Staphylococcus aureus and Streptococcus uberis. Also groups of pathogens were investigated, Gram-negative v. Gram-positive and contagious v. environmental pathogens. Data from 168 158 Danish Holstein cows calving first time between 1998 and 2006 were used in the analyses. Variances and covariances were estimated using uni- and bivariate threshold models via Gibbs sampling. Posterior means of heritabilities of pathogen-specific mastitis were lower than the heritability of unspecific mastitis, ranging from 0.035 to 0.076 for S. aureus and S. uberis, respectively. The heritabilities of groups of pathogen ranged from 0.053 to 0.087. Genetic correlations among the pathogen-specific mastitis traits ranged from 0.45 to 0.77. These estimates tended to be lowest for bacteria eliciting very different immune responses, which can be considered as the overall pleiotropic effect of genes affecting resistance to a specific pathogen, and highest for bacteria sharing characteristics regarding immune response. The genetic correlations between the groups of pathogens were high, 0.73 and 0.83. Results showed that the pathogen-specific traits used in this study should be considered as different traits. Genetic evaluation for pathogen-specific mastitis resistance may be beneficial despite lower heritabilities than unspecific mastitis because a pathogen-specific mastitis trait is a direct measure of an udder infection, and because the cost of a mastitis case caused by different pathogens has been shown to differ greatly. Sampling bias may be present because there were not pathogen information on all mastitis treatments and because some farms do not record pathogen information. Therefore, improved recording of pathogen information and mastitis treatments in general is critical for a successful genetic evaluation of udder health. Also, economic values have to be specified for each pathogen-specific trait separately.
To test the hypothesis that ammonia detoxification in ruminants consumes amino acids to the detriment of milk protein production, we infused four lactating dairy cows with ammonium acetate or sodium acetate in switchback experiments. Plasma ammonia concentrations increased to 411 μm within 1 h of the start of infusion of ammonium acetate at 567 mmol/h. The rate constant for ammonia clearance from plasma was 0·054/min and the half-life was 12·9 min. Infusion at 567 mmol/h for 1 h followed by 1 h without infusion, repeated four times between am- and pm-milking, caused a decrease in feed intake. Compared with sodium acetate, continuous infusion of ammonium acetate at 360 mmol/h throughout an entire 10-h milking interval increased plasma ammonia concentrations to 193 μm and caused a 20% decrease in milk, protein and lactose production with no effect on percentage composition of milk or the yield of milk fat. Arterial concentrations of glucose and non-esterified fatty acids tended to increase; there was no effect on arterial acetate, β-hydroxybutyrate or triacylglcerol, and branched-chain amino acids, Lys and Thr decreased. Mammary plasma flow, estimated by assuming 100% uptake/output of Phe+Tyr, was significantly correlated with milk yield. Mammary uptakes of acetate tended to be reduced by hyperammonaemia, but uptakes of other energy metabolites and amino acids were not affected. Thus, while an increase in amino acid consumption during hyperammonaemia was apparent from the drop in circulating concentrations of Leu, Ile, Val, Lys and Thr, there was no evidence to support the hypothesis that milk yield is affected by the lower concentrations. An ammonia-induced depression in feed intake may have caused the decrease in milk synthesis.
Dating and geomorphology of shoreline features in the Qinghai Lake basin of northwestern China suggest that, contrary to previous interpretations, the lake likely did not reach levels 66–140 m above modern within the past ∼ 90,000 yr. Maximum highstands of ∼ 20–66 m above modern probably date to Marine Isotope Stage (MIS) 5. MIS 3 highstands are undated and uncertain but may have been at or below post-glacial highs. The lake probably reached ∼ 3202–3206 m (+ 8–12 m) during the early Holocene but stayed below ∼ 3202 m after ∼ 8.4 ka. This shoreline history implies significantly different hydrologic balances in the Qinghai Lake basin before ∼ 90 ka and after ∼ 45 ka, possibly the result of a more expansive Asian monsoon in MIS 5.
Outdoor or organic farming demands robust chickens that are able to combat common infections before they spread to the flock. Priming the immune system of the chickens early in life with micro-organisms that they will encounter later in life prepares chickens to a life in environments where they are subjected to a more natural level of infection pressure. Also, exposure to non-infectious stressful situations may prepare the immune system to combat infectious challenges. The present study investigated whether the immune system could be primed by applying small doses of infective material to the chicken flock or by exposure to short-term non-infectious stimulation, and whether the effect of those stimuli would depend on the genetic material chosen. The effect of the stimulations was examined on selected immunological variables in two chicken strains, using small amounts of manure and litter from other chickens or short-term heat stress, respectively. After 6 weeks of treatment, all chickens were subjected to an Escherichia coli infection and followed for another 3 weeks. Measures of body weight gain, chicken mannan-binding lectin (cMBL), percentage of CD4+ and MHCII+ lymphocytes, mean fluorescence intensity (m.f.i.) of CD4 on CD4+ cells and MHCII on MHCII+ cells and antibody titres to E. coli were taken. In conclusion, the chickens redistribute lymphocyte populations in peripheral blood in response to potentially infectious agents as well as to stressful non-infectious treatments. Responses to stress situations were dependent on the frequencies of stress exposures and on the chicken breed. This may reflect the superiority of one breed over another in adapting to treatments or in discriminating whether a treatment is harmless or dangerous. However, the differences did not influence the disease resistance to infection with a mixture of E. coli O2, O11 and O78 in the present study.
We report a large foodborne outbreak due to group A streptococci (GAS), which caused acute tonsillo-pharyngitis in 200–250 patrons of a company canteen in Copenhagen, Denmark, in June 2006. A retrospective cohort study of canteen users showed that consumption of cold pasta was associated with an increased risk of illness (attack rate 68%, risk ratio 4·1, P<0·0001). Indistinguishable GAS strains (emm89, T-type 3/13/B3264) were cultured from three cases and a cook, who had prepared the pasta. To our knowledge, pasta has previously only twice been incriminated as the source of a GAS outbreak. Only six foodborne GAS outbreaks have been reported in Europe since 1970, four of them in Sweden or Denmark. This geographical clustering suggests that foodborne GAS outbreaks are probably under-recognized elsewhere.
This study compared the prevalence and intensity of infections of helminths in 2 chicken breeds in Vietnam, the indigenous Ri and the exotic Luong Phuong. Also, possible correlations with the Major Histocompatibility Complex (MHC) were tested. The most prevalent helminths were Ascaridia galli, Heterakis beramporia, Tetrameres mothedai, Capillaria obsignata, Raillietina echinobothrida and Raillietina tetragona. Differences in prevalence and intensity of infection were found between the 2 breeds. Comparing the 2 groups of adult birds, Ri chickens were observed to have higher prevalence and infection intensities of several species of helminths, as well as a higher mean number of helminth species. In contrast, A. galli and C. obsignata were shown to be more prevalent in Luong Phuong chickens. Furthermore, an age-dependent difference was indicated in the group of Ri chickens in which the prevalence and the intensity of infection was higher for the adult than the young chickens for most helminths. The most notable exception was the significantly lower prevalence and intensities of A. galli in the group of adult chickens. In contrast, the prevalence and intensity were very similar in both age groups of Luong Phuong chickens. Using a genetic marker located in the MHC, a statistically significant correlation between several MHC haplotypes and the infection intensity of different helminth species was inferred. This is the first report of an association of MHC haplotype with the intensity of parasite infections in chickens.
Changes in ultrasound measures of muscle area (UtM) during lactation in different breeds and parities and with different feeding levels were examined. Random regressions were fitted to repeated measures of UtM in order to study changes in variance components of UtM during lactation. Correlations between measures taken in different stages of lactation and in different parities were also calculated. The shape of UtM curves during lactation appeared to be fairly consistent for all breeds and parities. The lowest point of all curves coincided with the expected nadir of body reserves during lactation. With lower-than-normal feeding level, the drop of UtM after calving was deeper and the overall level was lower. A major proportion of the variance in UtM was found to be determined by additive genetic variation. In all three breeds studied, repeatability and heritability estimates were high and fairly consistent during lactation and between parities. The very high genetic correlations between measures taken in different periods of lactation suggested that muscle growth and recovery are controlled by the same gene complex throughout lactation.
Our results suggest that UtM, if used jointly with other body measures such as body condition score, could be a useful indicator of tissue mobilization and deposition in the lactating cow, especially during the early stage of lactation.
Shuidonggou is unique within the Chinese Palaeolithic sequence and its assemblage is reminiscent of Upper Palaeolithic core-and-blade technologies in Mongolia and southern Siberia. Limited chronological controls have prevented evaluation of this technology in both the Chinese and greater Eurasian Palaeolithic. Dating of recently discovered hearths at Locality 2 places Shuidonggou firmly at 29,000–24,000 BP, and suggests the spread of the Eurasian large blade technology was primarily from north to south. The concurrent production of small microblade-like bipolar bladelets at the site may also presage the development of a microlithic industry.
Background and objective The aim of this study was to determine possible age-associated differences in human blood pressure regulation during an immunological challenge in healthy subjects.
Methods Eight healthy young volunteers (median age 24 yr) and nine healthy elderly volunteers (median age 66 yr) received an intravenous bolus injection of Eschericia coli endotoxin (2 ng kg−1). Blood pressure, heart rate and core temperature were monitored during the first 7 h. Plasma catecholamine concentrations were measured at hourly intervals.
Results The elderly showed a significantly more pronounced decrease in mean arterial pressure 4–7 h after endotoxin administration compared with the young controls (anova; age × time; P < 0.0005). This mainly reflected a decrease in the systolic blood pressure in the elderly. The heart rate of both groups increased without difference between groups. Increased plasma epinephrine concentrations were found 2–3 h after endotoxin administration in both groups. Five hours after the endotoxin challenge, the epinephrine concentration had returned to control values in the elderly group only, in spite of decreased blood pressure.
Conclusion In conclusion, healthy elderly subjects fail to maintain a constant mean arterial pressure in response to the immunological challenge of endotoxemia.
Studies in 1961 and 1962 showed that several naturally occurring conditions suppress the pear psylla. Temperatures above 100°F. caused mortality of nymphal stages and reduced adult oviposition. Crystallization of honeydew was a mortality factor in a few instances, and seemed to be associated with high temperature and low humidity. Absence of new growth and poor condition of leaves caused a steady decline in pear psylla numbers in abandoned orchards. Anthocoris antevolens White was an effective predator in unsprayed orchards and significantly reduced pear psylla populations. A parasite, Trechnites insidiosus (Crawford) was encountered, but its significance as a mortality agent was not determined.