Long-term care use after a stroke or femoral fracture and the role of family caregivers

Background: There has been a shift from institutional care towards home care, and from formal to informal care to contain long-term care (LTC) costs in many countries. However, substitution to home care or informal care might be harder to achieve for some conditions than for others. Therefore, insight is needed in differences in LTC use, and the role of potential informal care givers, across specific conditions. We analyze differences in LTC use of previously independent older patients after a fracture of femur and stroke, and in particular examine to what extent having a partner and children affects LTC use for these conditions. Methods: Using administrative data on Dutch previously independent older people (55+) with a fracture of femur or stroke in 2013, we investigate their LTC use in the year after the condition takes place. We use administrative treatment data to select individuals who were treated by a medical specialist for a stroke or femoral fracture in 2013. Subsequent LTC use is measured as using no formal care, home care, institutional care or being deceased at 13 consecutive four-weekly periods after initial treatment. We relate long-term care use to having a partner, having children, other personal characteristics and the living environment. Results: The probability to use no formal care 1 year after the initial treatment is equally high for both conditions, but patients with a fracture are more likely to use home care, while patients with a stroke are more likely to use institutional care or have died. Having a spouse has a negative effect on home care and institutional care use, but the timing of the effect, especially for institutional care, differs strongly between the two conditions. Having children also has a negative effect on formal care use, and this effect is consistently larger for patients with a fracture than patients with a stroke. Conclusion: As the condition and the effect of potential informal care givers matter for subsequent long-term care use, policy makers should take the expected prevalence of specific conditions within the older people population into account when designing long-term car

A skewer survey of the Galactic halo from deep CFHT and INT images

We study the density profile and shape of the Galactic halo using deep multicolour images from the MENeaCS and CCCP projects, over 33 fields selected to avoid overlap with the Galactic plane. Using multicolour selection and PSF homogenization techniques we obtain catalogues of F stars (near-main sequence turnoff stars) out to Galactocentric distances up to 60kpc. Grouping nearby lines of sight, we construct the stellar density profiles through the halo in eight different directions by means of photometric parallaxes. Smooth halo models are then fitted to these profiles. We find clear evidence for a steepening of the density profile power law index around R=20 kpc, from -2.50 +- 0.04 to -4.85 +- 0.04, and for a flattening of the halo towards the poles with best-fit axis ratio 0.63 +- 0.02. Furthermore, we cannot rule out a mild triaxiality (w>=0.8). We recover the signatures of well-known substructure and streams that intersect our lines of sight. These results are consistent with those derived from wider but shallower surveys, and augur well for upcoming, wide-field surveys of comparable depth to our pencil beam surveys.Comment: 14 pages, 8 figures, 6 table

The dynamics of z~1 clusters of galaxies from the GCLASS survey

We constrain the internal dynamics of a stack of 10 clusters from the GCLASS survey at 0.87<z<1.34. We determine the stack cluster mass profile M(r) using the MAMPOSSt algorithm of Mamon et al., the velocity anisotropy profile beta(r) from the inversion of the Jeans equation, and the pseudo-phase-space density profiles Q(r) and Qr(r), obtained from the ratio between the mass density profile and the third power of the (total and, respectively, radial) velocity dispersion profiles of cluster galaxies. Several M(r) models are statistically acceptable for the stack cluster (Burkert, Einasto, Hernquist, NFW). The total mass distribution has a concentration c=r200/r-2=4.0-0.6+1.0, in agreement with theoretical expectations, and is less concentrated than the cluster stellar-mass distribution. The stack cluster beta(r) is similar for passive and star-forming galaxies and indicates isotropic galaxy orbits near the cluster center and increasingly radially elongated with increasing cluster-centric distance. Q(r) and Qr(r) are almost power-law relations with slopes similar to those predicted from numerical simulations of dark matter halos. Combined with results obtained for lower-z clusters we determine the dynamical evolution of galaxy clusters, and compare it with theoretical predictions. We discuss possible physical mechanisms responsible for the differential evolution of total and stellar mass concentrations, and of passive and star-forming galaxy orbits [abridged].Comment: 12 pages, 7 figures. Version accepted for publication in A&A after minor modification

Finding halo streams with a pencil-beam survey: new wraps in the Sagittarius stream

We use data from two CFHT-MegaCam photometric pencil-beam surveys in the g' and the r' bands to measure distances to the Sagittarius, the Palomar 5 and the Orphan stream. We show that, using a cross-correlation algorithm to detect the turnoff point of the main sequence, it is possible to overcome the main limitation of a two-bands pencil-beam survey, namely the lack of adjacent control-fields that can be used to subtract the foreground and background stars to enhance the signal on the colour-magnitude diagrams (CMDs). We describe the cross-correlation algorithm and its implementation. We combine the resulting main sequence turnoff points with theoretical isochrones to derive photometric distances to the streams. Our results (31 detections on the Sagittarius stream and one each for the Palomar 5 and the Orphan streams) confirm the findings by previous studies, expand the distance trend for the Sagittarius faint southern branch and, for the first time, trace the Sagittarius faint branch of the northern-leading arm out to 56 kpc. In addition, they show evidence for new substructure: we argue that these detections trace the continuation of the Sagittarius northern-leading arm into the southern hemisphere, and find a nearby branch of the Sagittarius trailing wrap in the northern hemisphere.Comment: 16 pages, 15 figures, 2 table

Temporal constraints on conscious vision: On the ubiquitous nature of the attentional blink

The attentional blink (AB) refers to the finding that observers often miss the second of two masked visual targets (T1 and T2, e.g., letters) appearing within 200-500 ms. Although the presence of a T1 mask is thought to be required for this effect, we recently found that an AB deficit can be observed even in the absence of a T1 mask if T2 is shown very briefly and followed by a pattern mask (M. R. Nieuwenstein, M. C. Potter, & J. Theeuwes, 2009). Using such a sensitive T2 task, the present study sought to determine the minimum requirements for eliciting an AB deficit. To this end, we examined if the occurrence of an AB depends on T1 exposure duration, the requirement to perform a task for T1, and awareness of T1. The results showed that an AB deficit occurs regardless of the presentation duration of T1, and regardless of whether there is a T1 task. A boundary condition for the occurrence of an AB was found in conscious awareness of T1. With a near-threshold detection task for T1, attention blinked when T1 was seen, but not when T1 was missed. Accordingly, we conclude that the minimum requirement for an AB deficit is T1 awareness. © ARVO

Investigating the on-demand service characteristics:an empirical study

Purpose Technological developments and new customer expectations of immediacy have driven businesses to adopt on-demand service models. The purpose of this paper is to study the characteristics of a range of on-demand services in order to better understand the meaning of "on-demand" and its implications for service management. This enables the on-demand service logic to be applied to other service contexts, where it may add value for customers. Design/methodology/approach The study starts with a focused literature review and continues with a multiple case study methodology, as the on-demand service concept is in the early stages of theory development. Seven cases were studied, based on a maximum variation sampling strategy. Findings The results show that on-demand services are characterized by three interrelated characteristics: being highly available, responsive and scalable. Analysis further reveals that on-demand services display differences within the conceptual boundaries of these characteristics, i.e. they vary in terms of their availability, responsiveness and scalability. Originality/value Drawing on these findings, the study contributes to the service literature by being the first to specifically conceptualize and define the on-demand services concept and reveal three key characteristics that clarify the distinctive nature of this service type. Accordingly, on-demand services are clearly differentiated from other services. Additionally, the paper discusses the variety within on-demand services and develops an on-demand service continuum that gives detailed insights into the conceptual variations within such services