Unmet need and psychological distress predict emergency department visits in community-dwelling elderly women: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Unmet need to perform activities of daily living (ADL) is associated with increased use of urgent health services by the elderly. However, the reported associations may be confounded by psychological distress. We examine the independent effects of unmet need and psychological distress upon emergency department (ED) visits.</p> <p>Methods</p> <p>We conducted a prospective study of randomly selected community-dwelling adults aged ≥ 75. We report here the results for women only (n = 530). In-person interviews collected data on self-reported unmet need and the 14-item <it>l'Indice de détresse psychologique de Santé Québec </it>psychological distress scale. ED visits were identified from an administrative database. Multivariable logistic regression was used to identify predictors of any ED visit in the 6 months following the baseline interview.</p> <p>Results</p> <p>In multivariable analysis, unmet need in instrumental ADL was associated with subsequent ED visits (odds ratio = 1.57, 95% confidence interval = 1.02-2.41), as was psychological distress (odds rate = 1.30, 95% confidence interval = 1.02-1.67). The magnitude of the association between unmet need and ED visits was overestimated in statistical models that did not adjust for psychological distress.</p> <p>Conclusions</p> <p>Both unmet need and psychological distress were independent predictors of ED visits. Future investigations of unmet need and health services utilization should include psychological distress to control for confounding and improve the internal validity of statistical models.</p

Bisulfite Sequencing Reveals That Aspergillus flavus Holds a Hollow in DNA Methylation

Aspergillus flavus first gained scientific attention for its production of aflatoxin. The underlying regulation of aflatoxin biosynthesis has been serving as a theoretical model for biosynthesis of other microbial secondary metabolites. Nevertheless, for several decades, the DNA methylation status, one of the important epigenomic modifications involved in gene regulation, in A. flavus remains to be controversial. Here, we applied bisulfite sequencing in conjunction with a biological replicate strategy to investigate the DNA methylation profiling of A. flavus genome. Both the bisulfite sequencing data and the methylome comparisons with other fungi confirm that the DNA methylation level of this fungus is negligible. Further investigation into the DNA methyltransferase of Aspergillus uncovers its close relationship with RID-like enzymes as well as its divergence with the methyltransferase of species with validated DNA methylation. The lack of repeat contents of the A. flavus' genome and the high RIP-index of the small amount of remanent repeat potentially support our speculation that DNA methylation may be absent in A. flavus or that it may possess de novo DNA methylation which occurs very transiently during the obscure sexual stage of this fungal species. This work contributes to our understanding on the DNA methylation status of A. flavus, as well as reinforces our views on the DNA methylation in fungal species. In addition, our strategy of applying bisulfite sequencing to DNA methylation detection in species with low DNA methylation may serve as a reference for later scientific investigations in other hypomethylated species

Evaluating the Change in Space in a Technology-Enabled Primary Years Setting

There has been considerable attention in the literature postulating the potential effects of contemporary, technology-enabled new generation learning spaces (NGLS) on both teaching and learning (Brooks, 2011, 2012). This has, in part, been driven by the pervasive and transformative potentiall of ubiquitous access to and use of digital technology in the classroom (Chan et al., 2006). Increased access to mobile technology in recent years has freed students from the restrictive nature of shared access in tradiitional computer laboratories (Blackmore, Bateman, O'Mara, & Loughlin, 2011). Students now have personal 'anywhere, anytime' access to a boundless library of highly indexed information (Beichner, 2014), which in turn challenges the highly sequential style of instruction that has allowed teachers to preserve their historically authoritative role. Personal access to technology can support more adaptive and connected learning experiences. These experiences are created by connecting teachers and students within multimodalities of teaching and },earning that may have not been possible before (Bocconi, Karnpylis, & Punie, 2012; Hall-van den Elsen & Palaskas, 2014; Swan, van'T Hooft, Kratcoski, & Schenk,er, 2007). Multimodalities afford teachers the ability to orchestrate adaptive learning opportunities using a range of physical, text and visual tools, whilst connecting students with each other. A key element is the connectivity between teachers-students and students-students is established through the creaition of technology-enabled NGLS. The technology-enabled spaces have ubiquitous access to digital technology through one-to-one digital devices connected through wireless infrastructure. The affordances of a NGLS environment has the potential to revolutionize how, where and with whom students learn (Mouza & Lavigne, 2013; Thomas & Brown, 2011). It has the potential to sup,port contemporary pedagogical practices that facilitate highly personalised models of student learning (Bocconi et al., 2012; Magee, 2009; Zandvliet & Fraser, 2004). This personalised model includes learning outside the primacy of the traditional classroom forum (Mouza & Lavigne, 2013). Together these elements intertwine to create a model of teaching and learning that can be radically different to prevailing school cultures (Mouza & Lavigne, 2013)

Oestrogen receptors and breast cancer. are we prepared to move forward? A critical review

It is nearly 60 years since the identification of the oestrogen hormone receptor (ER) in breast cancer, a discovery that radically transformed the clinical management of the disease. Hormonal therapy with anti-oestrogens (Tamoxifen and Aromatase inhibitors) antagonise ER function and became the mainstay treatment until today. Around 70% of breast tumours are classified as oestrogen dependent, yet the mechanism of action of other hormones in breast cancer growth both independently and interacting with ER as well as their targeted therapies have yet to find a place in the clinic. In this article, I critically review the scientific literature for the period 1960-2016, examine the rise and persistence of the oestrogen hypothesis as well as the neglect of alternative hormonal explanations. By using Pierre Bourdieu’s concepts of the scientific field alongside feminist science scholars to explore the impact of gendered assumptions on science, the analysis provides insight into the dominant role of the oestrogen hypothesis and the struggles for legitimation of different alternative perspectives. I consider these alternative approaches as “internal” struggles for scientific authority, which are in turn, socially determined by “external” gender values that reinforce a binary arrangement of male/female bodies based on fixed molecular hormonal traits