The AdHOC study of older adults’ adherence to medication in 11 countries

BACKGROUND: Compared with the resources expended developing, evaluating and making clinical decisions about prescribing medication, we know little about what determines whether people take it. Older adults are prescribed more medication than any other group. Poor adherence is a common reason for nonresponse to medication. OBJECTIVES: To investigate cross-nationally the impact of demographic, psychiatric (including cognitive), physical health, behavioural and medication factors on adherence to medication in older adults. METHODS: Researchers interviewed 3881 people over 65 who receive home care services using a structured interview at participants’ places of residence in eleven countries. The main outcome measure was the percentage participants not adherent to medication. RESULTS: 12.5% (n= 456) of people reported they were not fully adherent to medication. Non-adherence was predicted by problem drinking (OR=3.6), not having a doctor review medication (OR=3.3), dementia (OR=1.4 for every one point increase in impairment), good physical health (OR=1.2), resisting care (OR=2.1) being married (OR=2.3) and living in the Czech Republic (OR=4.7) or Germany (OR=1.4). CONCLUSION: People, who screen positive for problem drinking and with dementia, often undiagnosed are less likely to adhere to medication. Therefore doctors should consider dementia and problem drinking when prescribing for older adults. Interventions to improve adherence in older adults might be more effective if 4 targeted at these groups. It is possible that medication review enhances adherence, by improving the patient-doctor relationship, or by emphasising the relevance of medications

Negative Cell Cycle Regulation and DNA Damage-inducible Phosphorylation of the BRCT Protein 53BP1

In a screen designed to discover suppressors of mitotic catastrophe, we identified the Xenopus ortholog of 53BP1 (X53BP1), a BRCT protein previously identified in humans through its ability to bind the p53 tumor suppressor. X53BP1 transcripts are highly expressed in ovaries, and the protein interacts with Xp53 throughout the cell cycle in embryonic extracts. However, no interaction between X53BP1 and Xp53 can be detected in somatic cells, suggesting that the association between the two proteins may be developmentally regulated. X53BP1 is modified via phosphorylation in a DNA damage-dependent manner that correlates with the dispersal of X53BP1 into multiple foci throughout the nucleus in somatic cells. Thus, X53BP1 can be classified as a novel participant in the DNA damage response pathway. We demonstrate that X53BP1 and its human ortholog can serve as good substrates in vitro as well as in vivo for the ATM kinase. Collectively, our results reveal that 53BP1 plays an important role in the checkpoint response to DNA damage, possibly in collaboration with ATM

Iron Oxide Grains in Stardust Track 121 Grains as Evidence of Comet Wild 2 Hydrothermal Alteration

Stardust Track 121 terminal grains contain Fe-oxide. These are consistent with the presence of hydrothermal alteration on the Comet Wild 2 parent body

Growth mechanisms of perturbations in boundary layers over a compliant wall

The temporal modal and nonmodal growth of three-dimensional perturbations in the boundary-layer flow over an infinite compliant flat wall is considered. Using a wall-normal velocity/wall-normal vorticity formalism, the dynamic boundary condition at the compliant wall admits a linear dependence on the eigenvalue parameter, as compared to a quadratic one in the canonical formulation of the problem. This greatly simplifies the accurate calculation of the continuous spectrum by means of a spectral method, thereby yielding a very effective filtering of the pseudospectra as well as a clear identification of instability regions. The regime of global instability is found to be matching the regime of the favorable phase of the forcing by the flow on the compliant wall so as to enhance the amplitude of the wall. An energy-budget analysis for the least-decaying hydroelastic (static-divergence, traveling-wave-flutter and near-stationary transitional) and Tollmien--Schlichting modes in the parameter space reveals the primary routes of energy flow. Moreover, the flow exhibits a slower transient growth for the maximum growth rate of a superposition of streamwise-independent modes due to a complex dependence of the wall-boundary condition with the Reynolds number. The initial and optimal perturbations are compared with the boundary-layer flow over a solid wall; differences and similarities are discussed. Unlike the solid-wall case, viscosity plays a pivotal role in the transient growth. A slowdown of the maximum growth rate with the Reynolds number is uncovered and found to originate in the transition of the fluid-solid interaction from a two-way to a one-way coupling. Finally, a term-by-term energy budget analysis is performed to identify the key contributors to the transient growth mechanism

Pleural mesothelioma and lung cancer risks in relation to occupational history and asbestos lung burden.

BACKGROUND: We have conducted a population-based study of pleural mesothelioma patients with occupational histories and measured asbestos lung burdens in occupationally exposed workers and in the general population. The relationship between lung burden and risk, particularly at environmental exposure levels, will enable future mesothelioma rates in people born after 1965 who never installed asbestos to be predicted from their asbestos lung burdens. METHODS: Following personal interview asbestos fibres longer than 5 µm were counted by transmission electron microscopy in lung samples obtained from 133 patients with mesothelioma and 262 patients with lung cancer. ORs for mesothelioma were converted to lifetime risks. RESULTS: Lifetime mesothelioma risk is approximately 0.02% per 1000 amphibole fibres per gram of dry lung tissue over a more than 100-fold range, from 1 to 4 in the most heavily exposed building workers to less than 1 in 500 in most of the population. The asbestos fibres counted were amosite (75%), crocidolite (18%), other amphiboles (5%) and chrysotile (2%). CONCLUSIONS: The approximate linearity of the dose-response together with lung burden measurements in younger people will provide reasonably reliable predictions of future mesothelioma rates in those born since 1965 whose risks cannot yet be seen in national rates. Burdens in those born more recently will indicate the continuing occupational and environmental hazards under current asbestos control regulations. Our results confirm the major contribution of amosite to UK mesothelioma incidence and the substantial contribution of non-occupational exposure, particularly in women

Brain neurons as quantum computers: {\it in vivo} support of background physics

The question: whether quantum coherent states can sustain decoherence, heating and dissipation over time scales comparable to the dynamical timescales of the brain neurons, is actively discussed in the last years. Positive answer on this question is crucial, in particular, for consideration of brain neurons as quantum computers. This discussion was mainly based on theoretical arguments. In present paper nonlinear statistical properties of the Ventral Tegmental Area (VTA) of genetically depressive limbic brain are studied {\it in vivo} on the Flinders Sensitive Line of rats (FSL). VTA plays a key role in generation of pleasure and in development of psychological drug addiction. We found that the FSL VTA (dopaminergic) neuron signals exhibit multifractal properties for interspike frequencies on the scales where healthy VTA dopaminergic neurons exhibit bursting activity. For high moments the observed multifractal (generalized dimensions) spectrum coincides with the generalized dimensions spectrum calculated for a spectral measure of a {\it quantum} system (so-called kicked Harper model, actively used as a model of quantum chaos). This observation can be considered as a first experimental ({\it in vivo}) indication in the favour of the quantum (at least partially) nature of the brain neurons activity

The role of the individual in the coming era of process-based therapy

For decades the development of evidence-based therapy has been based on experimental tests of protocols designed to impact psychiatric syndromes. As this paradigm weakens, a more process-based therapy approach is rising in its place, focused on how to best target and change core biopsychosocial processes in specific situations for given goals with given clients. This is an inherently more idiographic question than has normally been at issue in evidence-based therapy over the last few decades. In this article we explore methods of assessment and analysis that can integrate idiographic and nomothetic approaches in a process-based era.Accepted manuscrip

Research opportunities with compact accelerator-driven neutron sources

Since the discovery of the neutron in 1934 neutron beams have been used in a very broad range of applications, As an aging fleet of nuclear reactor sources is retired the use of compact accelerator–driven neutron sources (CANS) are becoming more prevalent. CANS are playing a significant and expanding role in research and development in science and engineering, as well as in education and training. In the realm of multidisciplinary applications, CANS offer opportunities over a wide range of technical utilization, from interrogation of civil structures to medical therapy to cultural heritage study. This paper aims to provide the first comprehensive overview of the history, current status of operation, and ongoing development of CANS worldwide. The basic physics and engineering regarding neutron production by accelerators, target-moderator systems, and beam line instrumentation are introduced, followed by an extensive discussion of various evolving applications currently exploited at CANS

Direct grating writing: single-step Bragg grating and waveguide fabrication for telecommunications and sensing applications

Direct Grating Writing (DGW) has been developed over the past decade as a means of rapidly prototyping waveguides with integrated Bragg grating structures in silica-on-silicon substrates [1]. The technique allows complicated waveguide structures and Bragg grating arrays to be fabricated and characterised in house