Optimal management of urinary tract infections in older people

Urinary tract infections (UTI) occur frequently in older people. Unfortunately, UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary symptoms, with or without systemic symptoms. Urinalysis is commonly used to diagnose infection in this population, however, the evidence for its use is limited. There is overwhelming evidence that asymptomatic bacteriuria should not be treated. Catheter associated urinary tract infection accounts for a significant amount of hospital-associated infection. Indwelling urinary catheters should be avoided where possible and alternatives sought. The use of narrow spectrum antimicrobial agents for urinary tract infection is advocated. Local guidelines are now widely used to reflect local resistance patterns and available agents. Guidelines need to be updated to reflect changes in antimicrobial prescribing and a move from broad to narrow spectrum antimicrobials

The Effect of Storage, Processing and Enzyme Treatment on the Microstructure of Cloudy Spartan Apple Juice Particulate

The effect of blanching, post-harvest refrigerated (4C) storage and enzyme treatment with poly-galacturonase on the microstructure of Spartan apple juice was examined by thin sectioning and negative staining transmission electron microscopy. Particles were categrized as granules (3-54 nm), spheres (20-368 nm) and aggregates (12-2519 nm). Enzyme treatment with polygalacturonase significantly decreased granule size (P \u3c 0.01). Storage of apples significantly decreased both granule size (p \u3c 0.01) and aggregate length (p \u3c 0.05) and also resulted in a web-like aspect in the microscopic appearance of juice particulate. The web-like aspect of the particulate was removed either through enzyme treatment with polygalacturonase or by blanching. Blanching of puree significantly increased granule (p \u3c 0.05) and sphere size (p \u3c 0.01) while significantly decreasing aggregate length (p \u3c 0.01). In addition, blanching stabilized suspended particulate by what appeared to be the formation of a protective colloid which prevented particle aggregation through electrostatic repulsion

Stranded Structure Development in Thermally Produced Protein Concentrate Gel

Scanning electron micrographs of thermally induced whey protein concentrate gels were taken. Sample preparation was accomplished by glutaraldehyde fixation, osmium tetroxide post fixation and critical point dehydration. Stranded or beaded gel structures were observed on the external surface of a gas bubble, suggesting that a string-of-beads gel microstructure may result from bubble formation during thermal treatment

SOCIAL CAPITAL AND HOUSEHOLD INCOME DISTRIBUTIONS: EVIDENCE FROM MICHIGAN AND ILLINOIS

Social capital is a resource increasingly recognized as having important economic and social consequences. Robison and Siles (1999) examined some of these consequences at the U.S. state level and this study extends their efforts. Their 1999 study found important connections between the distributions of social capital and the distributions of household incomes. This study asks if the relationships between social capital and household incomes discovered at the state level are also present at the community level.Consumer/Household Economics, Institutional and Behavioral Economics,

Cryogenic and room temperature strength of sapphire jointed by hydroxide-catalysis bonding

Hydroxide-catalysis bonding is a precision technique used for jointing components in opto-mechanical systems and has been implemented in the construction of quasi-monolithic silica suspensions in gravitational wave detectors. Future detectors are likely to operate at cryogenic temperatures which will lead to a change in test mass and suspension material. One candidate material is mono-crystalline sapphire. Here results are presented showing the influence of various bonding solutions on the strength of the hydroxide-catalysis bonds formed between sapphire samples, measured both at room temperature and at 77 K, and it is demonstrated that sodium silicate solution is the most promising in terms of strength, producing bonds with a mean strength of 63 MPa. In addition the results show that the strengths of bonds were undiminished when tested at cryogenic temperatures

Poetic Threshold Moments: From Fledgling to Published Author

This paper presents perspectives from award-winning poets on an initiative where they were involved in publishing with undergraduate students who were completing a creative writing class at a tertiary education institution in NSW, Australia. This initiative provided students with the opportunity to be both taught by and publish with world-class poets. As a culmination of the semester’s class the students also had an opportunity for selected work to be published alongside high profile writers in a collaborative anthology. The recent Wording the World (2010) and Here Not There (2012) poetry anthologies are printed artefacts of this process. While reflecting on their experience of the initiative, the established writers provide interesting insights on the pedagogical value of such a program. It is also of interest to appreciate what motivates these poets to contribute their time and works to a project that assists student-writers to successfully cross a literary threshold. While reflecting on their journeys in achieving literary notoriety, the poets relate how they reached an understanding of threshold concepts associated with their identity as authors, their skills as writers, the way in which they influence other authors, and the way in which the writing community perceives them. One of the key findings that emerges from the study of this initiative, where the experts so generously give of themselves, is that through their experiences of the potentially isolating act of writing poetry when they were younger, they are able provide a sense of inclusivity and opportunity for newly emerging writers wishing to find a shape, voice and publication point for their creativity. Rather than seeing the process of poetry writing as a journey or a path, the data gathered from the established poets in this program indicates that there are a number of threshold points that poets experience as they move from being a fledgling to a published author

Structure and Composition of Apple Juice Haze

Haze obtained from commercial apple juice over the 1991 season contained from 11.4 to 29.0% protein (w/w) , trace quantities of both metal cations and polymeric carbohydrate, and gave strong responses to tests for phenolic compounds indicating a protein-phenol haze. SDS-PAGE of the 2-mercaptoethanol reduced , guanidinium hydrochloride dissaggregated haze particles gave a continuous smear indicating a population of molecules ranging from 29K to greater than 205K daltons. Transmission electron microscopy of negatively stained preparations revealed the presence of spherical bodies only partially penetrable by stain and possessin g a suhunit structure. These particles were embedded in a material presumably polymerized in such a way as to form chain-like aggregates. Protein-phenol haze particles consist of two structural components: spherical particles, probably protein , embedded in polymerized phenolics