Lack of meaningful activity on acute physical hospital wards: older peoples' experiences

Introduction: Research suggests that older people on acute physical hospital wards are at increased risk of physical and mental health decline due to inactivity during their stay. Whilst studies have highlighted potential causes of such inactivity, there exists a paucity of occupational therapy research that explores engagement in meaningful occupational from patients' perspectives in hospital settings. Method: Interpretative phenomenological analysis was used to gain a deeper understanding of how eighteen older people spent their time on hospital wards and the impact this had on their feelings of well-being. Interviews were carried out and analysed using Interpretive Phenomenological Analysis (IPA) guidelines. Findings: Patients experienced a lack of meaningful activity on the wards which resulted in feelings of passivity, boredom and sense of alienation from their normal roles, routines and sense of self. Despite a willingness to engage in activity, barriers were suggested as limited resources, hospital routines and personal limitations. Suggestions of potential meaningful activities were made. Conclusion: Occupational therapy services need to review service provision and provide an occupation-focused service, ensuring that patients' engagement in meaningful activities is seen as an integral part of their role in order to maintain patients' mental and physical well-being. Recommendations for further research are highlighted

De l’agressivité à la maternité. Étude longitudinale sur 30 ans auprès de filles agressives devenues mères : trajectoires de leur agressivité durant l’enfance, indicateurs de leurs caractéristiques parentales et développement de leurs enfants

L’agressivité chez les filles tend à ne pas se manifester de la même façon que chez les garçons ; de plus, elle suit une trajectoire longitudinale particulière. Les filles agressives envers leurs pairs ne se caractérisent pas tant par leurs manifestations de délinquance et de criminalité ; elles s’orientent plutôt vers une trajectoire de troubles sociaux et de santé mentale qui, à terme, compromet leur avenir scolaire, social et professionnel, de même que leur état de santé physique. Les compétences parentales des filles agressives, de même que le fonctionnement de leur famille, peuvent aussi être affectées ; dans ce cas, c’est la socialisation, la santé et le développement de toute une nouvelle génération d’enfants qui sont menacés. La Concordia Longitudinal Risk Project (Enquête longitudinale sur les risques, Université Concordia) suit un échantillon intergénérationnel de 1 770 sujets vivant à Montréal, dont un sous-échantillon de plus de 200 filles dites très agressives, et le compare avec un échantillon de garçons agressifs et un groupe témoin composé d’enfants des deux sexes. Les participants sont suivis de l’enfance à l’âge adulte sur une période de 30 ans. Le présent article décrit les trajectoires à long terme des filles agressives et les conséquences de cette agressivité sur une large variété d’éléments psychosociaux et de santé comme la maternité et la transmission des risques à la prochaine génération. Plus particulièrement, nous souhaitons : (1) établir les trajectoires des filles qui mènent de l’agressivité dans l’enfance au développement négatif à l’âge adulte, (2) établir les indicateurs de santé et les facteurs physiologiques connexes qui comportent des risques pour les filles agressives et leurs enfants et (3) évaluer comment l’agressivité à l’enfance se répercute sur le rôle maternel et le développement de la prochaine génération. Enfin, les retombées de nos conclusions seront discutées.Childhood aggression in girls may take different forms and follow different longitudinal trajectories from those typical of aggressive boys. Even when overt delinquency and criminality are avoided, girls who are aggressive towards their peers may follow a life course involving continuing social and mental health problems. From a longterm perspective, academic, social, health, and occupational achievement are likely to be negatively affected. Family functioning and parenting abilities may also be compromised, placing the offspring of these girls, a subsequent generation, at risk for social, health, and developmental problems. The Concordia Longitudinal Risk Project, which follows an intergenerational sample of 1770 inner-city Montrealers, includes a sub-sample of over 200 highly aggressive girls, with comparison groups of aggressive boys and normative children of both genders. Participants have been followed over a 30-year period, from childhood into adulthood. The present paper describes the long-term trajectories and sequelae of girlhood aggression in the context of a broad range of negative psychosocial and health outcomes, including parenting and the inter generational transfer of risk to offspring. More specifically, (1) trajectories by which childhood aggression places girls at risk for negative developmental outcomes are outlined, (2) health behaviours and physiological correlates that signify risk to aggressive girls and their offspring are delineated, and (3) pathways through which girlhood aggression influences parenting and offspring development are elucidated. Implications of these findings are discussed

Similar Biochemical Signatures and Prion Protein Genotypes in Atypical Scrapie and Nor98 Cases, France and Norway

Similarities raise questions regarding the origin of these recently described cases

A deep learning approach to photo–identification demonstrates high performance on two dozen cetacean species

We thank the countless individuals who collected and/or processed the nearly 85,000 images used in this study and those who assisted, particularly those who sorted these images from the millions that did not end up in the catalogues. Additionally, we thank the other Kaggle competitors who helped develop the ideas, models and data used here, particularly those who released their datasets to the public. The graduate assistantship for Philip T. Patton was funded by the NOAA Fisheries QUEST Fellowship. This paper represents HIMB and SOEST contribution numbers 1932 and 11679, respectively. The technical support and advanced computing resources from University of Hawaii Information Technology Services—Cyberinfrastructure, funded in part by the National Science Foundation CC* awards # 2201428 and # 2232862 are gratefully acknowledged. Every photo–identification image was collected under permits according to relevant national guidelines, regulation and legislation.Peer reviewedPublisher PD

Genetic Knock-Down of HDAC7 Does Not Ameliorate Disease Pathogenesis in the R6/2 Mouse Model of Huntington's Disease

Huntington's disease (HD) is an inherited, progressive neurological disorder caused by a CAG/polyglutamine repeat expansion, for which there is no effective disease modifying therapy. In recent years, transcriptional dysregulation has emerged as a pathogenic process that appears early in disease progression. Administration of histone deacetylase (HDAC) inhibitors such as suberoylanilide hydroxamic acid (SAHA) have consistently shown therapeutic potential in models of HD, at least partly through increasing the association of acetylated histones with down-regulated genes and by correcting mRNA abnormalities. The HDAC enzyme through which SAHA mediates its beneficial effects in the R6/2 mouse model of HD is not known. Therefore, we have embarked on a series of genetic studies to uncover the HDAC target that is relevant to therapeutic development for HD. HDAC7 is of interest in this context because SAHA has been shown to decrease HDAC7 expression in cell culture systems in addition to inhibiting enzyme activity. After confirming that expression levels of Hdac7 are decreased in the brains of wild type and R6/2 mice after SAHA administration, we performed a genetic cross to determine whether genetic reduction of Hdac7 would alleviate phenotypes in the R6/2 mice. We found no improvement in a number of physiological or behavioral phenotypes. Similarly, the dysregulated expression levels of a number of genes of interest were not improved suggesting that reduction in Hdac7 does not alleviate the R6/2 HD-related transcriptional dysregulation. Therefore, we conclude that the beneficial effects of HDAC inhibitors are not predominantly mediated through the inhibition of HDAC7

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Psychometric properties of three functional mobility tests for people with Parkinson’s disease

Background Standardized outcome measures with high clinical utility are of paramount importance for clinical practice. Objective The purpose of this study was to examine interrater and intrarater reliability, construct validity, discriminant ability, and smallest detectable differences of the sit-to-stand test (STS), Timed "Up & Go" Test (TUG), and bed mobility test for people with Parkinson disease (PD).DesignA cross-sectional, psychometric evaluation study was conducted. Methods A group of individuals with PD (PD group) and a group of individuals who were healthy (control group) were recruited through local PD groups and assessed in a movement laboratory in their "on" phase. Measurements of time to perform one STS, TUG, and bed mobility test were collected based on video recordings of that single performance. Results Thirty-eight individuals with PD (Hoehn and Yahr stages I-IV) and 19 age-matched control participants were recruited. Intraclass correlation coefficients for interrater and intrarater reliability for the PD group ranged from .95 to .99. Bland-Altman plots showed mean differences close to zero and narrow confidence intervals. Construct validity was established by means of moderate to good Spearman rho correlation coefficients with part III of the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr stage (range=.51-.63). Timings of all tests discriminated participants in the PD group from those in the control group and participants in the PD group in Hoehn and Yahr stages I and II from those in Hoehn and Yahr stages III and IV but did not discriminate "nonfallers" or those with single falls from repeat "fallers" or "nonfreezers" from "freezers." Applicable smallest detectable differences were established.LimitationsThe results are not generalizable to people in the late stage of PD (Hoehn and Yahr stage IV: n=3). Conclusions Timings of video recordings of 3 functional mobility tests with high clinical utility showed good psychometric properties for community-dwelling, ambulatory people with PD.status: publishe

Comparative analysis of Tritrichomonas foetus (Riedmuller, 1928) cat genotype, T. foetus (Riedmuller, 1928) cattle genotype and Tritrichomonas suis (Davaine, 1875) at 10 DNA loci

The parasitic protists in the genus Tritrichomonas cause significant disease in domestic cattle and cats. To assess the genetic diversity of feline and bovine isolates of Tritrichomonas foetus (Riedmüller, 1928) Wenrich and Emmerson, 1933, we used 10 different genetic regions, namely the protein coding genes of cysteine proteases 1, 2 and 4-9 (CP1, 2, 4-9) involved in the pathogenesis of the disease caused by the parasite. The cytosolic malate dehydrogenase 1 (MDH1) and internal transcribed spacer region 2 of the rDNA unit (ITS2) were included as additional markers. The gene sequences were compared with those of Tritrichomonas suis (Davaine, 1875) Morgan and Hawkins, 1948 and Tritrichomonas mobilensis Culberson et al., 1986. The study revealed 100% identity for all 10 genes among all feline isolates (=T. foetus cat genotype), 100% identity among all bovine isolates (=T. foetus cattle genotype) and a genetic distinctness of 1% between the cat and cattle genotypes of T. foetus. The cattle genotype of T. foetus was 100% identical to T. suis at nine loci (CP1, 2, 4-8, ITS2, MDH1). At CP9, three out of four T. suis isolates were identical to the T. foetus cattle genotype, while the T. suis isolate SUI-H3B sequence contained a single unique nucleotide substitution. Tritrichomonas mobilensis was 0.4% and 0.7% distinct from the cat and cattle genotypes of T. foetus, respectively. The genetic differences resulted in amino acid changes in the CP genes, most pronouncedly in CP2, potentially providing a platform for elucidation of genotype-specific host-pathogen interactions of T. foetus. On the basis of this data we judge T. suis and T. foetus to be subjective synonyms. For the first time, on objective nomenclatural grounds, the authority of T. suis is given to Davaine, 1875, rather than the commonly cited Gruby and Delafond, 1843. To maintain prevailing usage of T. foetus, we are suppressing the senior synomym T. suis Davaine, 1875 according to Article 23.9, because it has never been used as a valid name after 1899 and T. foetus is widely discussed as the cause of bovine trichomonosis. Thus bovine, feline and porcine isolates should all be given the name T. foetus. This promotes the stability of T. foetus for the veterinary and economically significant venereal parasite causing bovine trichomonosis