Assertive community treatment for elderly people with severe mental illness

Background: Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness.Methods: We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months.Discussion: This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated

The tumbling rotational state of 1I/‘Oumuamua

The discovery of 1I/2017 U1 (1I/‘Oumuamua) has provided the first glimpse of a planetesimal born in another planetary system. This interloper exhibits a variable colour within a range that is broadly consistent with local small bodies, such as the P- and D-type asteroids, Jupiter Trojans and dynamically excited Kuiper belt objects. 1I/‘Oumuamua appears unusually elongated in shape, with an axial ratio exceeding 5:1. Rotation period estimates are inconsistent and varied, with reported values between 6.9 and 8.3 h. Here, we analyse all the available optical photometry data reported to date. No single rotation period can explain the exhibited brightness variations. Rather, 1I/‘Oumuamua appears to be in an excited rotational state undergoing non-principal axis rotation, or tumbling. A satisfactory solution has apparent lightcurve frequencies of 0.135 and 0.126 h−1 and implies a longest-to-shortest axis ratio of ≳5:1, although the available data are insufficient to uniquely constrain the true frequencies and shape. Assuming a body that responds to non-principal axis rotation in a similar manner to Solar System asteroids and comets, the timescale to damp 1I/‘Oumuamua’s tumbling is at least one billion years. 1I/‘Oumuamua was probably set tumbling within its parent planetary system and will remain tumbling well after it has left ours

Knowledge dynamics in the tourism-social entrepreneurship nexus

Tourism is often employed as a vehicle for facilitating social-economic development, however its usefulness has been somewhat limited in relation to addressing social issues, and in particular, those issues relating to poverty. This is partly due to the lack of cross-sectoral interactions and knowledge exchange between private, public and third sectors that are needed to create effective and appropriate initiatives to leverage tourism for social benefits. Such traditional sectoral boundaries can be broken down through social entrepreneurship approaches which concomitantly, facilitate the creation and synergizing of social innovation that addresses persistent social issues. Yet to date, the utility of cross-sectoral knowledge dynamics still remains largely under-researched in both the social entrepreneurship and tourism literature. This chapter introduces readers to the concept of knowledge dynamics and discusses knowledge dynamics in the tourism and social entrepreneurship nexus via a case study of community-based tourism in Mai Hich, Vietnam. We argue that by gaining an enhanced understanding of cross-sectoral knowledge dynamics, we can strengthen the overall praxis of tourism and social entrepreneurship, and in particular, assist policymakers in fostering conditions that generate increased innovation.Griffith Business School, Department of Tourism, Sport and Hotel ManagementNo Full Tex

Effective suppression of Dengue fever virus in mosquito cell cultures using retroviral transduction of hammerhead ribozymes targeting the viral genome

Outbreaks of Dengue impose a heavy economic burden on developing countries in terms of vector control and human morbidity. Effective vaccines against all four serotypes of Dengue are in development, but population replacement with transgenic vectors unable to transmit the virus might ultimately prove to be an effective approach to disease suppression, or even eradication. A key element of the refractory transgenic vector approach is the development of transgenes that effectively prohibit viral transmission. In this report we test the effectiveness of several hammerhead ribozymes for suppressing DENV in lentivirus-transduced mosquito cells in an attempt to mimic the transgenic use of these effector molecules in mosquitoes. A lentivirus vector that expresses these ribozymes as a fusion RNA molecule using an Ae. aegypti tRNAval promoter and terminating with a 60A tail insures optimal expression, localization, and activity of the hammerhead ribozyme against the DENV genome. Among the 14 hammerhead ribozymes we designed to attack the DENV-2 NGC genome, several appear to be relatively effective in reducing virus production from transduced cells by as much as 2 logs. Among the sequences targeted are 10 that are conserved among all DENV serotype 2 strains. Our results confirm that hammerhead ribozymes can be effective in suppressing DENV in a transgenic approach, and provide an alternative or supplementary approach to proposed siRNA strategies for DENV suppression in transgenic mosquitoes

Estimates of probable dementia prevalence from population-based surveys compared with dementia prevalence estimates based on meta-analyses

<p>Abstract</p> <p>Background</p> <p>National data on dementia prevalence are not always available, yet it may be possible to obtain estimates from large surveys that include dementia screening instruments. In Australia, many of the dementia prevalence estimates are based on European data collected between 15 and 50 years ago. We derived population-based estimates of probable dementia and possible cognitive impairment in Australian studies using the Mini-Mental State Examination (MMSE), and compared these to estimates of dementia prevalence from meta-analyses of European studies.</p> <p>Methods</p> <p>Data sources included a pooled dataset of Australian longitudinal studies (DYNOPTA), and two Australian Bureau of Statistics National Surveys of Mental Health and Wellbeing. National rates of probable dementia (MMSE < 24) and possible cognitive impairment (24-26) were estimated using combined sample weights.</p> <p>Results</p> <p>Estimates of probable dementia were higher in surveys than in meta-analyses for ages 65-84, but were similar at ages 85 and older. Surveys used weights to account for sample bias, but no adjustments were made in meta-analyses. Results from DYNOPTA and meta-analyses had a very similar pattern of increase with age. Contrary to trends from some meta-analyses, rates of probable dementia were not higher among women in the Australian surveys. Lower education was associated with higher prevalence of probable dementia. Data from investigator-led longitudinal studies designed to assess cognitive decline appeared more reliable than government health surveys.</p> <p>Conclusions</p> <p>This study shows that estimates of probable dementia based on MMSE in studies where cognitive decline and dementia are a focus, are a useful adjunct to clinical studies of dementia prevalence. Such information and may be used to inform projections of dementia prevalence and the concomitant burden of disease.</p

Combining transcriptional profiling and genetic linkage analysis to uncover gene networks operating in hematopoietic stem cells and their progeny

Stem cells are unique in that they possess both the capacity to self-renew and thereby maintain their original pool as well as the capacity to differentiate into mature cells. In the past number of years, transcriptional profiling of enriched stem cell populations has been extensively performed in an attempt to identify a universal stem cell gene expression signature. While stem-cell-specific transcripts were identified in each case, this approach has thus far been insufficient to identify a universal group of core “stemness” genes ultimately responsible for self-renewal and multipotency. Similarly, in the hematopoietic system, comparisons of transcriptional profiles between different hematopoietic cell stages have had limited success in revealing core genes ultimately responsible for the initiation of differentiation and lineage specification. Here, we propose that the combined use of transcriptional profiling and genetic linkage analysis, an approach called “genetical genomics”, can be a valuable tool to assist in the identification of genes and gene networks that specify “stemness” and cell fate decisions. We review past studies of hematopoietic cells that utilized transcriptional profiling and/or genetic linkage analysis, and discuss several potential future applications of genetical genomics