Schizophrenia in older adults

Although the number of persons over the age of 55 with schizophrenia is expected to double over the next 20 years, the research data on older people with schizophrenia is limited. This appears to be because until the middle of the 20th century, it was assumed that mental illness in older people was a part of the aging process and older people are often excluded from research investigations. There is a need for nursing research to explore how people with schizophrenia, as they age, learn to manage their problems, as well as how those who are first diagnosed with schizophrenia in later life adapt to their illness. Mental health nurses need to be cautious in assigning premature labels to older adults with mental illness that may lead to unsubstantiated assumptions about levels of disability. Instead, they should realize individual potential regarding undiscovered strengths and should attempt to create interventions that recognize and foster personal development for older adults with schizophrenia

British artists and early Italian art c. 1770-1845 : the pre Pre-Raphaelites?

This thesis examines the hitherto largely-overlooked multifarious response by British artists to early Italian art which pre-dated the activity of the Pre-Raphaelites and their greatest champion, John Ruskin. The title of this thesis does not endeavour to claim that the artists under examination consciously formed or naturally constituted a group with clearly defined common interests and aims, as was the case with their aforementioned successors. Rather, the collective ‘pre’ Pre-Raphaelites is intended to demonstrate that, contrary to the impression given by the standard scholarship on this area, there were British artists prior to the dawn of the Pre-Raphaelites who found worth in periods of art beyond what was conventionally considered both generally tasteful and also useful for an artist to imitate, and who indeed made many of the important steps which facilitated the Pre-Raphaelites’ rediscovery of early Italian art in the late 1840s. The temporal span of the main investigative thrust of this thesis is, approximately, 1770 - 1845. Its structure is intended to reflect the multiplicity of both the catalysts and then the subsequent responses of British artists to the Italian primitives. The first part of the thesis comprises a number of chapters which offer a broad contextual framework - encompassing analyses of taste, artistic education and historiography - within which the varied activities of the artists explored in the subsequent chapters are set. Parts two and three reveal the very different approaches taken by a series of artists in the decades either side of the turn of the century in their attempts to study, learn from and sometimes emulate the visual lessons of the past. Thus this thesis rescues the often marginalised contributions of a selection of British artists to the resurgence of interest in early Italian art, and demonstrates how fundamental their interpretive filter was for the nature of the quasi-revolution in taste in the last half of the nineteenth century

Synthesis and characterization of Mercury vapor Coordination Species Using 1,3-Benzenedioethanethiolate (BDET)

Mercury is a major pollutant in the air today. Some possible chelators that have been used are British anti-Lewisite (BAL) 2,3-dimercaptopropanol, dimercaptosuccinic acid (DMSA). diinercaptopropanesulfonic acid (DMPS). and 1,3-benzenediamidoethanethiolate (BDE\u27I1. All contain two thiol groups, which \u27capture\u27 the heavy mercury element. Due to their structure, they all differ in how well they bind to the mercury atom. BDET is the most recent and efficient chelate used. Statistics show that coal-fired power plants are the nation\u27s largest mercury polluter. Steps have been taken to lower the emission of this toxic metal by the Clean Air Act. However, recently The Bush Administration\u27s Air Pollution Plan undermines the act. It delays the expectations and plans of the Clean Air Act by 10 years [ 1]

Graduate Recital:Ben Roberts, Violin

Kemp Recital Hall Sunday Afternoon April 18, 1999 12:30 p.m

Enabling safer bathing for people living with epilepsy

This public involvement consultation (PIC) was set up to explore the opinions and ideas of people living with epilepsy for developing a full research project on the topic of prevention of drowning in the bath. The general advice available for people living with epilepsy (PLE) is to have showers instead of baths, or to have a chaperone and not to bath if alone (Epilepsy Action 2019). However, we know that people with epilepsy do have baths and have them alone, and that there are fatal and non-fatal accidents. Twelve people (7 men and 5 women) took part in the PIC via online meetings and written feedback. Principles of thematic content analysis were applied to detailed notes that were taken, and these were examined independently by the two authors to identify similarities and key issues. Seven categories were identified: Research issues and methods, encouraging language, advice and information, options available, consequences, influencing factors and perceptions of risk. The PIC confirmed that people do bathe alone and that the reasoning behind this is complex and warrants investigation. This includes consideration of language, emotions, personal biography and context, and the role of specialists.N/

Chemical and Physicochemical Pretreatment of Lignocellulosic Biomass: A Review

Overcoming the recalcitrance (resistance of plant cell walls to deconstruction) of lignocellulosic biomass is a key step in the production of fuels and chemicals. The recalcitrance is due to the highly crystalline structure of cellulose which is embedded in a matrix of polymers-lignin and hemicellulose. The main goal of pretreatment is to overcome this recalcitrance, to separate the cellulose from the matrix polymers, and to make it more accessible for enzymatic hydrolysis. Reports have shown that pretreatment can improve sugar yields to higher than 90% theoretical yield for biomass such as wood, grasses, and corn. This paper reviews different leading pretreatment technologies along with their latest developments and highlights their advantages and disadvantages with respect to subsequent hydrolysis and fermentation. The effects of different technologies on the components of biomass (cellulose, hemicellulose, and lignin) are also reviewed with a focus on how the treatment greatly enhances enzymatic cellulose digestibility

Pulp, Vol. 4 No. 1

This is the fourth issue of Pulp.https://scholarworks.sfasu.edu/pulp/1003/thumbnail.jp

Low molecular weight heparin downregulates tissue factor expression and activity by modulating growth factor receptor-mediated induction of nuclear factor-κB

Treatment of cancer patients with low molecular weight heparin (LMWH) appears to have beneficial effects. In this study, the influence of low molecular weight heparin (LMWH) on tissue factor (TF) expression and activity in five cell lines from various tissues was analysed and explored. Incubation of cells with LMWH (0-2000μg/ml) resulted in the downregulation of TF mRNA expression which was both LMWH concentration-dependent and time-dependent. Downregulation of TF was also measured as decreased cellular TF antigen and activity. Consistently, incubation of cells with LMWH suppressed the nuclear localisation and the transcriptional activity of NFκB. Decreased TF mRNA was largely achievable by incubating the cells with an NFκB inhibitor alone whilst incubation with betulinic acid to activate NFκB reversed the inhibitory influence of LMWH. Cells were also incubated with a range of concentrations of EGF (0-10ng/ml), bFGF (0-20ng/ml) or VEGF (0-4ng/ml) in the presence or absence of LMWH (200μg/ml) for 24h and TF antigen measured. Inclusion of LMWH reduced TF expression in response to EGF, bFGF or VEGF but TF expression was partially restored by increasing concentrations of the growth factors. We conclude that LMWH downregulates TF expression in vitro through a mechanism that involves interference with the function of growth factors which in turn is mediated through the downregulation of the transcriptional activity of NFκB. This mechanism may also explain some of the beneficial influences attributed to LMWH therapy in the treatment of cancer patients

Life\u27s Simple 7 and Health Care Utilization among the Framingham Generation III Cohort

Abstract Objective: To evaluate associations of cardiovascular health status with utilization of healthcare services. Methods: Our study included 3,786 participants from the Framingham Third Generation Cohort (enrollment: May 2008 – February 2011). LS7 0-14 point summary scores were categorized as “suboptimal” (score of 0-7) and “optimal” (score of 8-14). Participants were stratified into two utilization groups. Those with 0-1 utilizations were compared to those with 2 or more visits ( Super Users”). Logistic regression was used to estimate associations of the two LS7 categories with the odds of Super User utilization (models adjusted for age, sex, race, and education). Results: Compared to those with “suboptimal” LS7 scores, participants with “optimal” LS7 scores had a 40.5% lower odds (95% confidence interval: 28-51%) of being a “Super User” of health care services (p\u3c0.005). Conclusions: In a younger population, higher LS7 cardiovascular health metric scores were associated with lower utilization of costly health care services. Public Health Implications: These results may have implications for primary care physicians and other health professionals to help identify patients at risk for over-utilization of higher-cost health care services

Comparing alternating pressure mattresses and high-specification foam mattresses to prevent pressure ulcers in high-risk patients: the PRESSURE 2 RCT

Background: Pressure ulcers (PUs) are a burden to patients, carers and health-care providers. Specialist mattresses minimise the intensity and duration of pressure on vulnerable skin sites in at-risk patients. Primary objective: Time to developing a new PU of category ≥ 2 in patients using an alternating pressure mattress (APM) compared with a high-specification foam mattress (HSFM). Design: A multicentre, Phase III, open, prospective, planned as an adaptive double-triangular group sequential, parallel-group, randomised controlled trial with an a priori sample size of 2954 participants. Randomisation used minimisation (incorporating a random element). Setting: The trial was set in 42 secondary and community inpatient facilities in the UK. Participants: Adult inpatients with evidence of acute illness and at a high risk of PU development. Interventions and follow-up: APM or HSFM – the treatment phase lasted a maximum of 60 days; the final 30 days were post-treatment follow-up. Main outcome measures: Time to event. Results: From August 2013 to November 2016, 2029 participants were randomised to receive either APM (n = 1016) or HSFM (n = 1013). Primary end point – 30-day final follow-up: of the 2029 participants in the intention-to-treat population, 160 (7.9%) developed a new PU of category ≥ 2. There was insufficient evidence of a difference between groups for time to new PU of category ≥ 2 [Fine and Gray model HR 0.76, 95% confidence interval (CI) 0.56 to 1.04; exact p-value of 0.0890 and 2% absolute difference]. Treatment phase sensitivity analysis: 132 (6.5%) participants developed a new PU of category ≥ 2 between randomisation and end of treatment phase. There was a statistically significant difference in the treatment phase time-to-event sensitivity analysis (Fine and Gray model HR 0.66, 95% CI 0.46 to 0.93; p = 0.0176 and 2.6% absolute difference). Secondary end points – 30-day final follow-up: new PUs of category ≥ 1 developed in 350 (17.2%) participants, with no evidence of a difference between mattress groups in time to PU development, (Fine and Gray model HR 0.83, 95% CI 0.67 to 1.02; p-value = 0.0733 and absolute difference 3.1%). New PUs of category ≥ 3 developed in 32 (1.6%) participants with insufficient evidence of a difference between mattress groups in time to PU development (Fine and Gray model HR 0.81, 95% CI 0.40 to 1.62; p = 0.5530 and absolute difference 0.4%). Of the 145 pre-existing PUs of category 2, 89 (61.4%) healed – there was insufficient evidence of a difference in time to healing (Fine and Gray model HR 1.12, 95% CI 0.74 to 1.68; p = 0.6122 and absolute difference 2.9%). Health economics – the within-trial and long-term analysis showed APM to be cost-effective compared with HSFM; however, the difference in costs models are small and the quality-adjusted life-year gains are very small. There were no safety concerns. Blinded photography substudy – the reliability of central blinded review compared with clinical assessment for PUs of category ≥ 2 was ‘very good’ (kappa statistic 0.82, prevalence- and bias-adjusted kappa 0.82). Quality-of-life substudy – the Pressure Ulcer Quality of Life – Prevention (PU-QoL-P) instrument meets the established criteria for reliability, construct validity and responsiveness. Limitations: A lower than anticipated event rate. Conclusions: In acutely ill inpatients who are bedfast/chairfast and/or have a category 1 PU and/or localised skin pain, APMs confer a small treatment phase benefit that is diminished over time. Overall, the APM patient compliance, very low PU incidence rate observed and small differences between mattresses indicate the need for improved indicators for targeting of APMs and individualised decision-making. Decisions should take into account skin status, patient preferences (movement ability and rehabilitation needs) and the presence of factors that may be potentially modifiable through APM allocation, including being completely immobile, having nutritional deficits, lacking capacity and/or having altered skin/category 1 PU. Future work: Explore the relationship between mental capacity, levels of independent movement, repositioning and PU development. Explore ‘what works for whom and in what circumstances’. Trial registration: Current Controlled Trials ISRCTN01151335. Funding: This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 52. See the NIHR Journals Library website for further project information