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Improving quality of life (QOL) for people with dementia is a priority. In care homes, we often rely on proxy ratings from staff and family but we do not know if, or how, they differ in care homes.
We compared 1056 pairs of staff and family DEMQOL-Proxy ratings from 86 care homes across England. We explored factors associated with ratings quantitatively using multilevel modelling and, qualitatively, through thematic analysis of 12 staff and 12 relative interviews.
Staff and family ratings were weakly correlated (ρs = 0.35). Median staff scores were higher than family's (104 v. 101; p < 0.001). Family were more likely than staff to rate resident QOL as ‘Poor’ (χ2 = 55.91, p < 0.001). Staff and family rated QOL higher when residents had fewer neuropsychiatric symptoms and severe dementia. Staff rated QOL higher in homes with lower staff:resident ratios and when staff were native English speakers. Family rated QOL higher when the resident had spent longer living in the care home and was a native English. Spouses rated residents’ QOL higher than other relatives. Qualitative results suggest differences arise because staff felt good care provided high QOL but families compared the present to the past. Family judgements centre on loss and are complicated by decisions about care home placement and their understandings of dementia.
Proxy reports differ systematically between staff and family. Reports are influenced by the rater:staff and family may conceptualise QOL differently.
Recent reviews highlight the importance of the liver in the coordination of nutrient fluxes in support of pregnancy and lactation (e.g. Drackley et al., 2001). Mobilisation of body fat reserves in the late dry period and early lactation leads to an increase in uptake of non-esterified fatty acids (NEFA) by the liver. Their metabolic fate is either oxidation or esterification into triacylglycerides (TAG) that are either exported in very low density lipoproteins (VLDL) or accumulated within liver cells. Recent evidence indicates that TAG accumulation impairs ureagenic and gluconeogenic capacity of the liver, with consequent reductions in feed intake and milk yield, increased incidence of disease and decreased reproductive performance (Overton and Piepenbrink, 1999).
LiFTTM (NuTec Ltd.) is a proprietary mixture of B-group vitamins and methyl group donors (rumen protected choline, niacin, vitamin B12, biotin, folic acid and thiamine) designed to reduce the accumulation of TAG in the liver and accelerate VLDL export. The objective of this experiment was to evaluate the effect of LiFT on milk yield and composition and concentrations of metabolites in blood.
Water piracy by Ice Stream B, West Antarctica, may have caused neighboring Ice Stream C to stop. The modern hydrologic potentials near the upstream end of the main trunk of Ice Stream C are directing water from the C catchment into Ice Stream B. Interruption of water supply from the catchment would have reduced water lubrication on bedrock regions projecting through lubricating basal till and stopped the ice stream in a few years or decades, short enough to appear almost instantaneous. This hypothesis explains several new data sets from Ice Stream C and makes predictions that might be testable.
We present new far-infrared line observations of the planetary nebulae (PNs) NGC 7027, NGC 7009, NGC 6210, NGC 6543, and IC 4997 obtained with the Kuiper Airborne Observatory (KAO). The bulk of our data are for NGC 7027 and NGC 7009, including [Ne V] 24 μm, [O IV] 26 μm, [O III] (52, 88μm), and [Nm] 57 μm. Our data for [O III] (52, 88) and [N III] 57 in NGC 7027 represent the first measurements of these lines in this source. The large [O III] 52/88 flux ratio implies an electron density (cm–3) of log Ne[O III] = 4.19, the largest Ne ever inferred from these lines. We derive N++/O++ = 0.394±0.062 for NGC 7027 and 0.179±0.043 for NGC 6210. We are able to infer the O+3/O++ ionic ratio from our data. As gauged by this ionic ratio, NGC 7027 is substantially higher ionization than is NGC 7009 – consistent with our observation that the former produces copious [Ne V] emission while the latter does not. These data help characterize the stellar ionizing radiation field.
Galaxy-galaxy collisions are known to produce drastic changes in morphology and, in many cases, enhance the level of star formation activity in galaxies. In order to better quantify the effects that interactions have on the star formation characteristics of galaxies we have undertaken a multiwavelength survey of a large sample of interacting disk-type galaxies. The sample is optically-selected, the inclusion of systems having been based upon the presence of unusual morphological features—such as tidal tails, plumes, rings, warped disks—suggestive of tidal interaction. The sample is composed of about 115 systems, most of which are spiral-spiral pairs, with a few spiral-elliptical pairs and a few merging systems (see Bushouse 1986 for more details of the sample selection). This sample has now been studied in the optical, infrared, and radio regimes, including optical spectra and Ha images, near-infrared photometry and imaging, far-infrared photometry, HI 21cm emission-line measurements, VLA 20cm maps, and CO emission-line measurements. This paper presents an overview and comparison of the results of the optical, infrared and CO surveys. With these data we can compare the far-infrared and CO properties of the galaxies with the classic optical and radio indicators of star formation activity and thereby determine what, if any, relationships exist between star formation activity and the far-infrared and CO properties of the galaxies.
The extended timescales involved in the decay of radioactive wastes to safe levels mean that geological disposal facilities must continue to function effectively long into the future. It is therefore essential to consider long-term climate evolution in post-closure performance assessments in order to evaluate a geological disposal system's response and robustness to a variety of potential environmental changes, driven by both natural and anthropogenic forcings. In this paper, we illustrate the multiple decay components that characterize the primary driver of climate change – atmospheric CO2 – in response to fossil fuel carbon emissions. We perform a multi-exponential analysis on a series of atmospheric CO2 decay curves predicted by an Earth system model and create an empirical response function that encapsulates the long-term (>1 kyr) removal of excess CO2 from the atmosphere. We present this response function as a simple tool for rapidly projecting the future atmospheric CO2 concentration resulting from any plausible cumulative release of CO2. We discuss the implications of the long 'tail' to this atmospheric CO2 decay curve, both in terms of future climate evolution as well as potential impacts on radioactive waste repositories.
§ 1. To test whether or not the Röntgen rays have any electrifying effect on air, the following arrangement was made.
A lead cylinder 76 cms. long, 23 cms. diameter, was constructed; and both ends were closed with paraffined cardboard, transparent to the Röntgen rays. Outside the end distant from the electrometer (see diagram 1) a Röntgen lamp was placed. In the other end two holes were made, one in the middle, through which passed a glass tube (referred to below as suction pipe) of sufficient length to allow the end in the lead cylinder to be put into any desired place in the cylinder. By means of this, air was drawn through an electric filter by an air pump. The other hole, at a little distance from the centre, contained a second glass tube by which air was drawn through india-rubber tubing from the open-air quadrangle outside the laboratory.
In one series of experiments the end of the suction pipe was kept in the axial line of the lead cylinder at various points 10 cms. apart, beginning with a point close to the end distant from the Röntgen lamp.
In every case the air drawn through the filter was found to be negatively electrified when no screen or an aluminium screen was interposed between the Röntgen lamp and the near end of the lead cylinder. The air was found not electrified at all, or very slightly negative, when a lead screen was interposed.
ZnO nanowire (NW) arrays were examined with Transmission Electron Microscopy (TEM) in cross-section after preparation by Focused Ion Beam (FIB) milling. This technique revealed that ZnO nanowires grown using a Au catalyzed vapor technique typically have Au particles at the NW tips, and also randomly dispersed across the base crystal growth that joins adjacent NWs. It is shown the adjacent NWs and the combined base growth is one crystal structure which can be used as a back electrical contact making fabrication of vertical array devices possible. However, the base growth displays detrimental features such as embedded Au particles and lattice defects which can affect the electrical output through depletion regions and scattering centers. In an effort to overcome these problems we investigate a growth method that is nucleated through a minor alteration of the a-plane sapphire surface roughness via a weak chemical etch. Observations of various stages of the growth show the growth nucleates as separate nanoislands that grow in c-plane alignment with Sapphire (1-210), and as growth continues these islands meet and form a polycrystalline film. Further growth initiates nanowire growth and the formation of a single crystal base layer and NW structure that can cover several square millimeter’s. This allows high quality arrays that are relatively free from defects to be formed without any metals contamination and ready for further device processing.
The purpose of this study was to extend the literature on the ontogeny of autism spectrum disorder (ASD) by examining early attainment and loss of specific sociocommunicative skills in children with autism (AUT; n = 125), pervasive developmental disorder not otherwise specified (PDD-NOS; n = 42), nonspectrum developmental delays (n = 46), and typical development (n = 31). The ages of skill attainment and loss were obtained from a caregiver interview. The findings indicated that children with AUT, PDD-NOS, and developmental delays diverged from typically developing children in attainment of sociocommunicative skills early in the first year of life. Loss of at least one skill was reported in a majority of children with AUT and PDD-NOS. Significant delays in attainment of skills were also reported in children who lost skills. The wide variation in skill attainment and loss reported across children indicates that symptom onset and regression may be best represented continuously, with at least some early delay and loss present for a great majority of children with ASD.
Risky decision making, a hallmark phenotype of substance use disorders (SUD), is thought to be associated with deficient feedback processing. Whether these aberrations are present prior to SUD onset or reflect merely a consequence of chronic substance use on the brain remains unclear. The present study investigated whether blunted feedback processing during risky decision making reflects a biological predisposition to SUD. We assessed event-related potentials elicited by positive and negative feedback during performance of a modified version of the Balloon Analogue Risk Task (BART) among high-risk adolescents with a parental history of SUD (HR; n = 61) and normal-risk controls (NR; n = 91). HR males made significantly more risky and faster decisions during the BART than did NR controls. Moreover, HR adolescents showed significantly reduced P300 amplitudes in response to both positive and negative feedback as compared to NR controls. These differences were not secondary to prolonged substance use exposure. Results are discussed in terms of feedback-specific processes. Reduced P300 amplitudes in the BART may reflect poor processing of feedback at the level of overall salience, which may keep people from effectively predicting the probability of future gains and losses. Though conclusions are tentative, blunted feedback processing during risky decision making may represent a promising endophenotypic vulnerability marker for SUD.
In recent years the number of pregnant women susceptible to rubella has increased markedly. In the West Midlands the proportion has risen from 1·4% in 2004 to 6·9% in 2011. Locally, the proportion of non-immune women ranges from 1·6% in those born prior to 1976 to 17·8% in those born since 1986. The latter group comprises those given MMR in their second year with no further booster doses. The number of non-immune women will continue to rise as a consequence of low MMR uptake in the late 1990s. Repeat testing of samples with values <10 IU/ml and the need to vaccinate women postnatally have increased the workload of laboratory and maternity units. Screening for rubella in pregnancy has no advantages for the current pregnancy and it may be time to review the universal MMR vaccination programme which in turn would remove the need for continuing this practice.
The effect of the diffusion of monatomic hydrogen into InGaAs/AlGaAs quantum wells has been investigated using photoluminescence (PL) and Secondary Ion Mass Spectroscopy (SIMS). The structures were grown by molecular beam epitaxy and hydrogenated with a remote plasma. For In0.2Ga0.8AlxGA1-xAs quantum wells, hydrogenation significant increases the integrated PL intensity from bound excitons at 77 K. The enhancement of the PL is ascribed to removal of nonradiative recombination centers by hydrogen passivation of defects either at the heterojunction interface or within the epilayers. This PL enhancement (and defect passivation) increases as the Al concentration in the AlGaAs layers increases from 0 to 33 at%. A 50% increase of PL intensity is observed for InGaAs/GaAs. For 33 at%, the increase is a factor of 9. We also diffused deuterium into these InGaAs/AlGaAs quantum wells. The enhancement of the PL by deuteration was similar to that by hydrogenation. The isotopie substitution permits the determination of the depth distribution of deuterium in the multilayered structure by SIMS. SIMS results support the conclusion that more defects are passivated in the higher Al concentration samples.
Although bats are one of the most successful and diverse of mammalian orders, studies that focus upon bat endoparasites are limited. To further knowledge of bat parasitology, pipistrelle bats (Pipistrellus pipistrellus and P. pygmaeus) were acquired from across the Greater Manchester and Lancashire region of England and examined for gastrointestinal helminths using morphological and molecular analyses†. Sixty-eight of 90 adult/juvenile bats (76% prevalence) were infected with at least 1 species of helminth and mean helminth abundance was 48·2 (+/−7·0). All helminths were digenean trematodes and the following species were identified in 51 P. pipistrellus specimens (prevalence in parentheses): Lecithodendrium linstowi (80·4%), L. spathulatum (19·6%), Prosthodendrium sp. (35·3%), Plagiorchis koreanus (29·4%) and Pycnoporus heteroporus (9·8%). Statistical analyses, incorporating multifactorial models, showed that male bats exhibited a significantly more aggregated helminth distribution and lower abundance than females. Positive associations were observed between L. linstowi and L. spathulatum, Prosthodendrium sp. and P. heteroporus and between L. spathulatum and P. koreanus. A revised phylogeny of bat-associated Lecithodendriidae, incorporating novel L. spathulatum and Prosthodendrium sp. 28S rRNA sequences, separated the controversial clade formed by L. linstowi and P. hurkovaae. Further studies are likely to assist the understanding of bat-parasite/pathogen relationships, helminth infracommunity structures and phylogenetics.
Within the Herschel key project “The Warm And Dense ISM” (WADI) we systematically observe
a number of prominent photon-dominated regions (PDRs) to measure the impact of varying UV
fields on the energy balance, the chemical and dynamical structure of heated molecular
The allostatic load (AL) model represents an interdisciplinary approach to comprehensively conceptualize and quantify chronic stress in relation to pathologies throughout the life cycle. This article first reviews the AL model, followed by interactions among early adversity, genetics, environmental toxins, as well as distinctions among sex, gender, and sex hormones as integral antecedents of AL. We next explore perspectives on severe mental illness, dementia, and caregiving as unique human models of AL that merit future investigations in the field of developmental psychopathology. A complimenting transdisciplinary perspective is applied throughout, whereby we argue that the AL model goes beyond traditional stress–disease theories toward the advancement of person-centered research and practice that promote not only physical health but also mental health.
United Solar Ovonic has leveraged its history of making amorphous silicon solar cells on stainless steel substrates to develop amorphous silicon alloy (a-Si:H)-based solar cells and modules on ∼25 μm thick polymer substrate using high-throughput roll-to-roll deposition technology for space and near-space applications. The solar cells have a triple-junction a-Si:H/a-SiGe:H/a-SiGe:H structure deposited by conventional plasma enhanced CVD (PECVD) using roll-to-roll processing. The cells have distinct advantages in terms of high specific power (W/kg), high flexibility, ruggedness, rollability for stowage, and irradiation resistance. The large area (23.9 cm x 32.1 cm) individual cells manufactured in large quantity can be readily connected into modules and have achieved initial, 25 °C, AM0 aperture-area efficiency of 9.8% and initial specific power of 1200 W/kg. We have conducted light-soak studies and measured the temperature coefficient of the current-voltage characteristics to determine the stable values at an expected operating temperature of 60 °C. The stable total-area efficiency and specific power at 60 °C are 7.2% and 950 W/kg, respectively. In this paper, we review the challenges and progress made in development of the cells, highlight some applications, and discuss current efforts aimed at improving performance.
Mass casualty triage is the process of prioritizing multiple victims when resources are not sufficient to treat everyone immediately. No national guideline for mass casualty triage exists in the United States. The lack of a national guideline has resulted in variability in triage processes, tags, and nomenclature. This variability has the potential to inject confusion and miscommunication into the disaster incident, particularly when multiple jurisdictions are involved. The Model Uniform Core Criteria for Mass Casualty Triage were developed to be a national guideline for mass casualty triage to ensure interoperability and standardization when responding to a mass casualty incident. The Core Criteria consist of 4 categories: general considerations, global sorting, lifesaving interventions, and individual assessment of triage category. The criteria within each of these categories were developed by a workgroup of experts representing national stakeholder organizations who used the best available science and, when necessary, consensus opinion. This article describes how the Model Uniform Core Criteria for Mass Casualty Triage were developed.
(Disaster Med Public Health Preparedness. 2011;5:129-137)
A systematic study has been made of amorphous silicon (a-Si) alloy solar cells using various hydrogen dilutions during the growth of the intrinsic (i) layer. We find that the open-circuit voltage (Voc) of the cells increases as the dilution increases; it then reaches a maximum before it decreases dramatically. This sudden drop in Voc is attributed to the transition from amorphous silicon to microcrystalline inclusions in the i layer. We study i-layer thicknesses ranging from 1000 Å to 5000 Å and find that the transition occurs in all thicknesses investigated. Based on this study, a-Si alloy p i n solar cells suitable for use in the top cell of a high efficiency triple-junction structure are made. By selecting an appropriate dilution, cells with Voc greater than 1 V can be achieved readily. Solar cells made near the threshold not only exhibit higher initial characteristics but also better stability against light soaking. We have compared top cells made near the threshold with our previous best data, and found that both the initial and stable efficiencies are superior for the near-threshold cells. For an a-Si/a-Si double-junction device, a Voc value exceeding 2 V has been obtained using thin component cells. Thicker component cells give rise to an initial active-area efficiency of 11.9% for this tandem structure.