Older Adults, Perseverance Strategies, and Serious Leisure Activities: A Qualitative Study

Participation in serious leisure is shown to promote overall healthy aging. One quality of serious leisure is participants’ ability to persevere when facing obstacles to participation. There is limited research on perseverance strategies within the domain of serious leisure, particularly in an aging context. This study aimed to explore perseverance strategies used by older adults while they engaged in endurance sports as a form of serious leisure. Two overarching research questions were presented: What perseverance strategies were used, and when were these strategies used? This study used qualitative description methodology with a phenomenological approach. Data were collected through semi-structured interviews and underwent thematic analysis. There were 15 participants (average age 67 years) who were active in running, cycling, swimming, kayaking, and triathlons. Findings demonstrated that different perseverance strategies were used by participants as they went through the four action phases of Gollwitzer (1990)’s goal pursuit process

Older Adults, Perseverance Strategies, and Serious Leisure Activities: A Qualitative Study

Participation in serious leisure is shown to promote overall healthy aging. One quality of serious leisure is participants ability to persevere when facing obstacles to participation. There is limited research on perseverance strategies within the domain of serious leisure, particularly in an aging context. This study aimed to explore perseverance strategies used by older adults while they engaged in endurance sports as a form of serious leisure. Two overarching research questions were presented: What perseverance strategies were used, and when were these strategies used? This study used qualitative description methodology with a phenomenological approach. Data were collected through semi-structured interviews and underwent thematic analysis. There were 15 participants (average age 67 years) who were active in running, cycling, swimming, kayaking, and triathlons. Findings demonstrated that different perseverance strategies were used by participants as they went through the four action phases of Gollwitzer (1990)s goal pursuit process

10-Year Mortality Outcome of a Routine Invasive Strategy Versus a Selective Invasive Strategy in Non-ST-Segment Elevation Acute Coronary Syndrome: The British Heart Foundation RITA-3 Randomized Trial.

BACKGROUND: The RITA-3 (Third Randomised Intervention Treatment of Angina) trial compared outcomes of a routine early invasive strategy (coronary arteriography and myocardial revascularization, as clinically indicated) to those of a selective invasive strategy (coronary arteriography for recurrent ischemia only) in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). At a median of 5 years' follow-up, the routine invasive strategy was associated with a 24% reduction in the odds of all-cause mortality. OBJECTIVES: This study reports 10-year follow-up outcomes of the randomized cohort to determine the impact of a routine invasive strategy on longer-term mortality. METHODS: We randomized 1,810 patients with NSTEACS to receive routine invasive or selective invasive strategies. All randomized patients had annual follow-up visits up to 5 years, and mortality was documented thereafter using data from the Office of National Statistics. RESULTS: Over 10 years, there were no differences in mortality between the 2 groups (all-cause deaths in 225 [25.1%] vs. 232 patients [25.4%]: p = 0.94; and cardiovascular deaths in 135 [15.1%] vs. 147 patients [16.1%]: p = 0.65 in the routine invasive and selective invasive groups, respectively). Multivariate analysis identified several independent predictors of 10-year mortality: age, previous myocardial infarction, heart failure, smoking status, diabetes, heart rate, and ST-segment depression. A modified post-discharge Global Registry of Acute Coronary Events (GRACE) score was used to calculate an individual risk score for each patient and to form low-risk, medium-risk, and high-risk groups. Risk of death within 10 years varied markedly from 14.4 % in the low-risk group to 56.2% in the high-risk group. This mortality trend did not depend on the assigned treatment strategy. CONCLUSIONS: The advantage of reduced mortality of routine early invasive strategy seen at 5 years was attenuated during later follow-up, with no evidence of a difference in outcome at 10 years. Further trials of contemporary intervention strategies in patients with NSTEACS are warranted. (Third Randomised Intervention Treatment of Angina trial [RITA-3]; ISRCTN07752711)

The potential of decentralised wastewater treatment in urban and rural sanitation in South Africa: lessons learnt from a demonstration-scale DEWATS within the eThekwini Municipality

The design principles of decentralised wastewater treatment systems (DEWATS) make them a practical sanitation option for municipalities to adopt in fast-growing cities in South Africa. Since 2014, a demonstration scale DEWATS with a modular design consisting of a settler, anaerobic baffled reactor (ABR), anaerobic filter (AF), vertical down-flow constructed wetland (VFCW) and horizontal flow constructed wetland (HFCW) has been in operation in eThekwini. A performance evaluation after the long-term operation was undertaken in 2019 by comparing the final effluent with national regulatory requirements. Despite limitations in characterising the raw wastewater, a comparison of the settler and final effluent quality indicated high (≥ 85%) removal efficiencies of total chemical oxygen demand (CODt), ammonium-N (NH4-N) and orthophosphate-P (PO4-P), 75% removal of total suspended solids (TSS) and 83.3% log10 removal of Escherichia coli. Lack of exogenous and endogenous carbon and high dissolved oxygen (DO) concentrations (> 0.5 mg·L−1) inhibited denitrification in the HFCW, resulting in 12.5% of the effluent samples achieving compliance for nitrate-N (NO3-N). Moreover, mixed aggregate media and low residence times in the HFCW may have also contributed to poor NO3-N removal. During the COVID-19 lockdown, an unexpected shutdown and subsequent resumption of flow to the DEWATS indicated a 16-week recovery time based on achieving full nitrification in the HFCW. Although design modifications are necessary for the HFCW, the installation of urine diversion flushing toilets at the household level will reduce the nutrient loading to the DEWATS and potentially achieve fully compliant effluent. Alternatively, the application of two-stage vertical flow constructed wetlands to improve denitrification should also be explored in the South African context. With an improved design, DEWATS has the potential to fill the gap in both urban and rural sanitation in South Africa, where waterborne sanitation is still desired but connections to conventional wastewater treatment works (WWTWs) are not possible.&nbsp

Evolution of faecal sludge chemical and physical characteristics during drying

The effect of drying on faecal sludge chemical and physical properties for its reuse as agricultural product and biofuel was explored in this investigation. The nutrient content, calorific value and thermal properties were determined for faecal sludge samples dried at different moisture contents, in two different drying apparatus, one based on convective drying and the other on infrared drying. The results show that the nutrient content and calorific value were not affected during drying. On the contrary, drying modified the chemical form of nitrogen in the sludge, by binding it more tightly to the solid structure. Moreover, drying led to the increase of the thermal diffusivity, which improves its quality as biofuel by enhancing its ability to conduct heat. Faecal sludge, after being dried, could be used in agriculture as an organic fertilizer of slow nitrogen and phosphorous release, and as a biofuel with similar characteristics than wood

Overcoming barriers to engaging socio-economically disadvantaged populations in CHD primary prevention: a qualitative study

<p><b>Background:</b> Preventative medicine has become increasingly important in efforts to reduce the burden of chronic disease in industrialised countries. However, interventions that fail to recruit socio-economically representative samples may widen existing health inequalities. This paper explores the barriers and facilitators to engaging a socio-economically disadvantaged (SED) population in primary prevention for coronary heart disease (CHD).</p> <p><b>Methods:</b> The primary prevention element of Have a Heart Paisley (HaHP) offered risk screening to all eligible individuals. The programme employed two approaches to engaging with the community: a) a social marketing campaign and b) a community development project adopting primarily face-to-face canvassing. Individuals living in areas of SED were under-recruited via the social marketing approach, but successfully recruited via face-to-face canvassing. This paper reports on focus group discussions with participants, exploring their perceptions about and experiences of both approaches.</p> <p><b>Results:</b> Various reasons were identified for low uptake of risk screening amongst individuals living in areas of high SED in response to the social marketing campaign and a number of ways in which the face-to-face canvassing approach overcame these barriers were identified. These have been categorised into four main themes: (1) processes of engagement; (2) issues of understanding; (3) design of the screening service and (4) the priority accorded to screening. The most immediate barriers to recruitment were the invitation letter, which often failed to reach its target, and the general distrust of postal correspondence. In contrast, participants were positive about the face-to-face canvassing approach. Participants expressed a lack of knowledge and understanding about CHD and their risk of developing it and felt there was a lack of clarity in the information provided in the mailing in terms of the process and value of screening. In contrast, direct face-to-face contact meant that outreach workers could explain what to expect. Participants felt that the procedure for uptake of screening was demanding and inflexible, but that the drop-in sessions employed by the community development project had a major impact on recruitment and retention.</p> <p><b>Conclusion:</b> Socio-economically disadvantaged individuals can be hard-to-reach; engagement requires strategies tailored to the needs of the target population rather than a population-wide approach.</p&gt

Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study.

OBJECTIVE: To describe contemporary patient characteristics and treatment patterns, including antithrombotic management, of post-myocardial infarction (MI) stable coronary artery disease (CAD) patients at high atherothrombotic risk from different geographical regions. METHODS: Patients ≥50years with prior MI 1-3years ago and ≥1 risk factor (age ≥65years, diabetes, 2nd prior MI >1yr ago, multivessel CAD, creatinine clearance 15-1year was highest (39%) in Asia-Pacific and lowest (12%) in Europe. CONCLUSIONS: Despite guideline recommendations, 1 in 4 post-MI patients did not receive DAPT for ~1year. In contrast to guideline recommendations supporting newer ADPris, clopidogrel was mainly prescribed. Prior to recent RCT data supporting DAPT >1year post-MI/PCI, >1 in 4 patients have continued on DAPT, though with substantial international variability

Intelligence within BAOR and NATO's Northern Army Group

During the Cold War the UK's principal military role was its commitment to the North Atlantic Treaty Organisation (NATO) through the British Army of the Rhine (BAOR), together with wartime command of NATO's Northern Army Group. The possibility of a surprise attack by the numerically superior Warsaw Pact forces ensured that great importance was attached to intelligence, warning and rapid mobilisation. As yet we know very little about the intelligence dimension of BAOR and its interface with NATO allies. This article attempts to address these neglected issues, ending with the impact of the 1973 Yom Kippur War upon NATO thinking about warning and surprise in the mid-1970s. It concludes that the arrangements made by Whitehall for support to BAOR from national assets during crisis or transition to war were - at best - improbable. Accordingly, over the years, BAOR developed its own unique assets in the realm of both intelligence collection and special operations in order to prepare for the possible outbreak of conflict

Multiplex detection of the big five carbapenemase genes using solid-phase recombinase polymerase amplification

Five carbapenemase enzymes, coined the ‘big five’, have been identified as the biggest threat to worldwide antibiotic resistance based on their broad substrate affinity and global prevalence. Here we show the development of a molecular detection method for the gene sequences from the five carbapenemases utilising the isothermal amplification method of recombinase polymerase amplification (RPA). We demonstrate the successful detection of each of the big five carbapenemase genes with femtomolar detection limits using a spatially separated multiplex amplification strategy. The approach uses tailed oligonucleotides for hybridisation, reducing the complexity and cost of the assay compared to classical RPA detection strategies. The reporter probe, horseradish peroxidase, generates the measureable output on a benchtop microplate reader, but more notably, our study leverages the power of a portable Raman spectrometer, enabling up to a 19-fold enhancement in the limit of detection. Significantly, the development approach employed a solid-phase RPA format, wherein the forward primers targeting each of the five carbapenemase genes are immobilised to a streptavidin-coated microplate. The adoption of this solid-phase methodology is pivotal for achieving a successful developmental pathway when employing this streamlined approach. The assay takes 2 hours until result, including a 40 minutes RPA amplification step at 37 °C. This is the first example of using solid-phase RPA for the detection of the big five and represents a milestone towards the developments of an automated point-of-care diagnostic for the big five using RPA

Humoral and cellular responses to SARS-CoV-2 in patients with B-cell haematological malignancies improve with successive vaccination

Patients with haematological malignancies are more likely to have poor responses to vaccination. Here we provide detailed analysis of the humoral and cellular responses to COVID-19 vaccination in 69 patients with B-cell malignancies. Measurement of anti-spike IgG in serum demonstrated a low seroconversion rate with 27.1% and 46.8% of patients seroconverting after the first and second doses of vaccine, respectively. In vitro pseudoneutralisation assays demonstrated a poor neutralising response, with 12.5% and 29.5% of patients producing a measurable neutralising titre after the first and second doses, respectively. A third dose increased seropositivity to 54.3% and neutralisation to 51.5%, while a fourth dose further increased both seropositivity and neutralisation to 87.9%. Neutralisation titres post-fourth dose showed a positive correlation with the size of the B-cell population measured by flow cytometry, suggesting an improved response correlating with recovery of the B-cell compartment after B-cell depletion treatments. In contrast, interferon gamma ELISpot analysis showed a largely intact T-cell response, with the percentage of patients producing a measurable response boosted by the second dose to 75.5%. This response was maintained thereafter, with only a small increase following the third and fourth doses, irrespective of the serological response at these timepoints