Epidemiology of population mortality related to falls in california 2000–2016: an increasing challenge for EMS

Background: Falls mortality increases with age and the U.S. population is aging steadily. This study examined the epidemiology of mortality in California this century due to unintentional falls. Method: Deaths caused by falls were extracted from California Department of Public Health data. Yearly Californian population estimates from the California Department of Finance were used to calculate the incidence of falls mortality. Results: There were 32 276 deaths attributed to falls, out of 618,589,117 person-years. Deaths at age ≥60 years accounted for 26 669 (83%). There were 15% more deaths during winter months, compared with summer. From age 70 mortality approximately doubled every five additional years of age. The age-adjusted falls mortality rate per 1 00 000 person-years (against the 2000 U.S. Standard Population) increased over 2000–2016 from 3.0 to 4.5 in females and from 8.9 to 9.8 in males. The number of falls deaths increased by a mean 77 per year, (95% CI 72, 83, R2=0.98, p<0.0001), doubling from 1251 in 2000 to 2582 in 2016. Conclusion: It may be prudent for EMS in California to anticipate continued increases in falls mortality. If the annual number of falls-related deaths continues to climb by an average of 77 deaths per year, then California will experience more than 3000 falls deaths per year sometime between 2025 and 2030. Recent increases were partly driven by a combination of increasing population and changes in the age distribution, however, age-adjusted mortality rates also increased, especially in females and older age groups. Conflict of interest None. Funding None

Recent Advances in Cytogenetic Technology for Antenatal Genetic Testing

The examination of human chromosomes has been a part of the physician’s laboratory armamentarium since the correct diploid number of human chromosomes was established and a method was developed for the in vitro growth of peripheral blood leukocytes to yield metaphase chromosomes. The discovery that on ultraviolet microscopy (UV), metaphase chromosomes stained with fluorochrome dyes displayed a characteristic pattern of bright and dull bands unique for a given pair of homologous chromosomes, was a major technological breakthrough in human cytogenetics; for the first time, every chromosome in the karyotype could be unequivocally identified. Although the short storage life of fluorochrome-stained chromosomes and the costs of UV microscopy have limited the usability of fluorescence banding, the introduction of one discriminating procedure quickly led to the development of an array of similar banding techniques for conventional microscopy that yield comparable information. Some of these technical procedures depend on enzyme and/or heat denaturation of the chromosomes, resulting in the characteristic banding patterns seen by the trypsin-Giemsa method, the 5M urea method, and the acid-saline-Giemsa technique. A typical human karyotype prepared from metaphase chromosomes treated with trypsin, stained with Giemsa, and photographed with brightfield photomicrographic techniques is shown in Figure 1. Careful examination of this karyotype reveals that each chromosome in the homologous pair has an array of dark and light bands identical with those of its homolog and that each homologous pair, autosomes number 1 to number 22, has a characteristic, easily identifiable banding pattern

Candida albicans Hypha Formation and Mannan Masking of β-Glucan Inhibit Macrophage Phagosome Maturation

Received 28 August 2014 Accepted 28 October 2014 Published 2 December 2014 This is an open-access article distributed under the terms of the Creative Commons Attribution 3.0 Unported license. ACKNOWLEDGMENTS We thank Janet Willment, Aberdeen Fungal Group, University of Aberdeen, for kindly providing the soluble Dectin-1-Fc reporter. All microscopy was performed with the assistance of the University of Aberdeen Core Microscopy & Histology Facility, and we thank the IFCC for their assistance with flow cytometry. We thank the Wellcome Trust for funding (080088, 086827, 075470, 099215, 097377, and 101873). E.R.B. and A.J.P.B. are funded by the European Research Council (ERC-2009-AdG-249793), and J.L. is funded by a Medical Research Council Clinical Training Fellowship.Peer reviewedPublisher PD

Planting the Seeds: Orchestral Music Education as a Context for Fostering Growth Mindsets

Growth mindset is an important aspect of children\u27s socioemotional development and is subject to change due to environmental influence. Orchestral music education may function as a fertile context in which to promote growth mindset; however, this education is not widely available to children facing economic hardship. This study examined whether participation in a program of orchestral music education was associated with higher levels of overall growth mindset and greater change in levels of musical growth mindset among children placed at risk by poverty. After at least 2 years of orchestral participation, students reported significantly higher levels of overall growth mindset than their peers; participating students also reported statistically significant increases in musical growth mindset regardless of the number of years that they were enrolled in orchestral music education. These findings have implications for future research into specific pedagogical practices that may promote growth mindset in the context of orchestral music education and more generally for future studies of the extra-musical benefits of high-quality music education

Feasibility and Impact of Telemonitor-Based Depression Care Management for Geriatric Homecare Patients

Objective: The objective of this study was to test the feasibility, acceptability, and preliminary clinical outcomes of a method to leverage existing home healthcare telemonitoring technology to deliver depression care management (DCM) to both Spanish- and English-speaking elderly homebound recipients of homecare services. Materials and Methods: Three stand-alone, nonprofit community homecare agencies located in New York, Vermont, and Miami participated in this study. Evidence-based DCM was adapted to the telemonitor platform by programming questions and educational information on depression symptoms, antidepressant adherence, and side effects. Recruited patients participated for a minimum of 3 weeks. Telehealth nurses were trained on DCM and received biweekly supervision. On-site trained research assistants conducted in-home research interviews on depression diagnosis and severity and patient satisfaction with the protocol. Results: An ethnically diverse sample of 48 English- and Spanish-only- speaking patients participated, along with seven telehealth nurses. Both patients and telehealth nurses reported high levels of protocol acceptance. Among 19 patients meeting diagnostic criteria for major depression, the mean depression severity was in the markedly severe range at baseline and in the mild range at follow-up. Conclusions: Results of this pilot support the feasibility of using homecare\u27s existing telemonitoring technology to deliver DCM to their elderly homebound patients. This was true for both English- and Spanish-speaking patients. Preliminary clinical outcomes suggest improvement in depression severity, although these findings require testing in a randomized clinical trial. Implications for the science and service of telehealth-based depression care for elderly patients are discussed

Racial Differences in Neighborhood Perceptions and their Influences on Physical Activity among Urban Older Women

Background: Proper levels of physical activity (PA) are important to healthy aging. Little is known about racial differences in influences of neighborhood perceptions (NP) on PA and use of neighborhood resources among community-dwelling older women. Materials and methods: In 2014 and 2015, 49 white and 44 black women of age 65 and older living in Washington, DC were queried about their PA, NP, use of neighborhood resources and sociodemographic characteristics. They wore an accelerometer and a Global Positioning System device concurrently for 7 consecutive days. Data were analyzed by race. Results: Compared to Whites, Blacks had lower NP scores (71% positive vs. 77%, p = 0.01), lower mean daily step counts (mean (SD): 3256 (1918) vs. 5457 (2989), p \u3c 0.001), and lower frequencies of all exercise activities combined (19.7 (8.7) vs. 25.2 (11.8) per week, p = 0.01). For both Whites and Blacks, better NPs were associated with more frequent PA both at (p = 0.05) and away from home (p = 0.01). However, better NPs were associated with higher frequencies of exercise activities, moderate-to-high intensity activities, and utilitarian walking for Whites but not Blacks (p \u3c 0.05 for race-perception interaction terms). Conclusions: In an urban setting, older Black women were more likely than older White women to have poor NPs, less PA, and weaker or no association of positive NPs with higher levels of certain PAs. Such substantial racial differences warrant further investigation and consideration in health promotion programs

Covalently Cross-Linked Nanoparticles Based on Ferulated Arabinoxylans Recovered from a Distiller’s Dried Grains Byproduct

The purpose of this investigation was to extract ferulated arabinoxylans (AX) from dried distillers’ grains with solubles (DDGS) plus to investigate their capability to form covalently cross-linked nanoparticles. AX registered 7.3 µg of ferulic acid/mg polysaccharide and molecular weight and intrinsic viscosity of 661 kDa and 149 mL/g, correspondingly. Fourier transform infrared spectroscopy (FTIR) was used to confirm the identity of this polysaccharide. AX formed laccase induced covalent gels at 1% (w/v), which registered an elastic modulus of 224 Pa and a content of FA dimers of 1.5 µg/mg polysaccharide. Scanning electron microscopy pictures of AX gels exhibited a microstructure resembling a rough honeycomb. AX formed covalently cross-linked nanoparticles (NAX) by coaxial electrospray. The average hydrodynamic diameter of NAX determined by dynamic light scattering was 328 nm. NAX presented a spherical and regular shape by transmission electron microscopy analysis. NAX may be an attractive material for pharmaceutical and biomedical applications and an option in sustainable DDGS use