Grandparents as caregivers : common questions (2008)

"Information from Human Environmental Sciences Extension.""Human development."New 4/08/2M

Impact of Design Interventions in Nursing Home on Residents with Dementia, Their Families, and the Staff

The purpose of this study was to determine whether certain design interventions in a nursing home affected resident with dementia outcomes, family involvement and interaction, and staff perceptions of care delivery. The study was conducted in a nursing home. The study site included dining and bathing facilities that serve smaller groups of residents. The new design promised to contrast the medical orientation of the existing nursing home with a more residential environment. The study design involved a two-group pretest-posttest comparison in which a sample of residents who eventually were relocated to the newly designed wing of the facility (Treatment Group) was compared with a sample that remained in the existing setting (Control Group). Findings and implication of this study provide new knowledge integrating the diverse professional aspects that contribute to a responsive long-term care setting.https://dc.uwm.edu/caupr_mono/1011/thumbnail.jp

Addressing challenges and opportunities of the European seafood sector under a circular economy framework

The European seafood and aquaculture sectors are facing important challenges in terms of environmental threats (climate change, marine debris, resources depletion), social development (worker rights, consumer's awareness) or economic growth (market and nonmarket goods and services, global competitiveness). These issues are forcing all stakeholders, from policy-makers to citizens and industries, to move to more sustainable policies, practices and processes. Consequently, an improvement in collaborations among different parties and beyond borders is required to create more efficient networks along the supply chain of seafood and aquaculture sectors. To achieve this, a "nexus thinking" approach (i.e. the analysis of actions in connected systems) combined with a life cycle thinking appears as an excellent opportunity to facilitate the transition to a circular economy.This work was supported by the EAPA_576/2018 NEPTUNUS project. The authors would like to acknowledge the financial support of Interreg Atlantic Area. A.C. Dias and P. Quinteiro acknowledge FCT/MCTES for the contracts CEECIND/02174/2017 and CEECIND/00143/2017, respectively, and for the financial support to CESAM (UID/AMB/50017/2019), through national funds. The Portuguese Foundation for Science and Technology (FCT) for supporting the contract of A. Marques in the framework of the IF2014 program (IF/00253/2014)

Effects of uremia and inflammation on growth hormone resistance in patients with chronic kidney diseases

Resistance to the anabolic action of growth hormone may contribute to the loss of strength and muscle mass in adult patients with chronic kidney disease. We tested this hypothesis by infusing growth hormone in patients to levels necessary to saturate hormone receptors. This led to a significant decrease of plasma potassium and amino acid levels in control and hyperkalemic patients with chronic kidney disease. These effects were completely or partially blunted in patients with elevated C-reactive protein levels. In forearm perfusion studies, growth hormone caused a further decrease in the negative potassium and protein balance of hemodialysis patients without inflammation but no effect was seen in patients with inflammation. Only IL-6 levels and age were found to be independent correlates in these growth hormone-induced variations in plasma potassium and blood amino acids. This shows that although a resistance to pharmacologic doses of growth hormone is not a general feature of patients with chronic kidney disease, there is a subgroup characterized by blunted growth hormone action. Our results support the hypothesis that uremia with inflammation, but not uremia per se, inhibits downstream growth hormone signaling contributing to muscle atrophy

Consensus Guidelines for Digital Scholarship in Academic Promotion.

INTRODUCTION: As scholarship moves into the digital sphere, applicant and promotion and tenure (P&T) committee members lack formal guidance on evaluating the impact of digital scholarly work. The P&T process requires the appraisal of individual scholarly impact in comparison to scholars across institutions and disciplines. As dissemination methods evolve in the digital era, we must adapt traditional P&T processes to include emerging forms of digital scholarship. METHODS: We conducted a blended, expert consensus procedure using a nominal group process to create a consensus document at the Council of Emergency Medicine Residency Directors Academic Assembly on April 1, 2019. RESULTS: We discussed consensus guidelines for evaluation and promotion of digital scholarship with the intent to develop specific, evidence-supported recommendations to P&T committees and applicants. These recommendations included the following: demonstrate scholarship criteria; provide external evidence of impact; and include digital peer-review roles. As traditional scholarship continues to evolve within the digital realm, academic medicine should adapt how that scholarship is evaluated. P&T committees in academic medicine are at the epicenter for supporting this changing paradigm in scholarship. CONCLUSION: P&T committees can critically appraise the quality and impact of digital scholarship using specific, validated tools. Applicants for appointment and promotion should highlight and prepare their digital scholarship to specifically address quality, impact, breadth, and relevance. It is our goal to provide specific, timely guidance for both stakeholders to recognize the value of digital scholarship in advancing our field

A prospective prostate cancer screening programme for men with pathogenic variants in mismatch repair genes (IMPACT): initial results from an international prospective study.

Funder: Victorian Cancer AgencyFunder: NIHR Manchester Biomedical Research CentreFunder: Cancer Research UKFunder: Cancer Council TasmaniaFunder: Instituto de Salud Carlos IIIFunder: Cancer AustraliaFunder: NIHR Oxford Biomedical Research CentreFunder: Fundación Científica de la Asociación Española Contra el CáncerFunder: Cancer Council South AustraliaFunder: Swedish Cancer SocietyFunder: NIHR Cambridge Biomedical Research CentreFunder: Institut Català de la SalutFunder: Cancer Council VictoriaFunder: Prostate Cancer Foundation of AustraliaFunder: National Institutes of HealthBACKGROUND: Lynch syndrome is a rare familial cancer syndrome caused by pathogenic variants in the mismatch repair genes MLH1, MSH2, MSH6, or PMS2, that cause predisposition to various cancers, predominantly colorectal and endometrial cancer. Data are emerging that pathogenic variants in mismatch repair genes increase the risk of early-onset aggressive prostate cancer. The IMPACT study is prospectively assessing prostate-specific antigen (PSA) screening in men with germline mismatch repair pathogenic variants. Here, we report the usefulness of PSA screening, prostate cancer incidence, and tumour characteristics after the first screening round in men with and without these germline pathogenic variants. METHODS: The IMPACT study is an international, prospective study. Men aged 40-69 years without a previous prostate cancer diagnosis and with a known germline pathogenic variant in the MLH1, MSH2, or MSH6 gene, and age-matched male controls who tested negative for a familial pathogenic variant in these genes were recruited from 34 genetic and urology clinics in eight countries, and underwent a baseline PSA screening. Men who had a PSA level higher than 3·0 ng/mL were offered a transrectal, ultrasound-guided, prostate biopsy and a histopathological analysis was done. All participants are undergoing a minimum of 5 years' annual screening. The primary endpoint was to determine the incidence, stage, and pathology of screening-detected prostate cancer in carriers of pathogenic variants compared with non-carrier controls. We used Fisher's exact test to compare the number of cases, cancer incidence, and positive predictive values of the PSA cutoff and biopsy between carriers and non-carriers and the differences between disease types (ie, cancer vs no cancer, clinically significant cancer vs no cancer). We assessed screening outcomes and tumour characteristics by pathogenic variant status. Here we present results from the first round of PSA screening in the IMPACT study. This study is registered with ClinicalTrials.gov, NCT00261456, and is now closed to accrual. FINDINGS: Between Sept 28, 2012, and March 1, 2020, 828 men were recruited (644 carriers of mismatch repair pathogenic variants [204 carriers of MLH1, 305 carriers of MSH2, and 135 carriers of MSH6] and 184 non-carrier controls [65 non-carriers of MLH1, 76 non-carriers of MSH2, and 43 non-carriers of MSH6]), and in order to boost the sample size for the non-carrier control groups, we randomly selected 134 non-carriers from the BRCA1 and BRCA2 cohort of the IMPACT study, who were included in all three non-carrier cohorts. Men were predominantly of European ancestry (899 [93%] of 953 with available data), with a mean age of 52·8 years (SD 8·3). Within the first screening round, 56 (6%) men had a PSA concentration of more than 3·0 ng/mL and 35 (4%) biopsies were done. The overall incidence of prostate cancer was 1·9% (18 of 962; 95% CI 1·1-2·9). The incidence among MSH2 carriers was 4·3% (13 of 305; 95% CI 2·3-7·2), MSH2 non-carrier controls was 0·5% (one of 210; 0·0-2·6), MSH6 carriers was 3·0% (four of 135; 0·8-7·4), and none were detected among the MLH1 carriers, MLH1 non-carrier controls, and MSH6 non-carrier controls. Prostate cancer incidence, using a PSA threshold of higher than 3·0 ng/mL, was higher in MSH2 carriers than in MSH2 non-carrier controls (4·3% vs 0·5%; p=0·011) and MSH6 carriers than MSH6 non-carrier controls (3·0% vs 0%; p=0·034). The overall positive predictive value of biopsy using a PSA threshold of 3·0 ng/mL was 51·4% (95% CI 34·0-68·6), and the overall positive predictive value of a PSA threshold of 3·0 ng/mL was 32·1% (20·3-46·0). INTERPRETATION: After the first screening round, carriers of MSH2 and MSH6 pathogenic variants had a higher incidence of prostate cancer compared with age-matched non-carrier controls. These findings support the use of targeted PSA screening in these men to identify those with clinically significant prostate cancer. Further annual screening rounds will need to confirm these findings. FUNDING: Cancer Research UK, The Ronald and Rita McAulay Foundation, the National Institute for Health Research support to Biomedical Research Centres (The Institute of Cancer Research and Royal Marsden NHS Foundation Trust; Oxford; Manchester and the Cambridge Clinical Research Centre), Mr and Mrs Jack Baker, the Cancer Council of Tasmania, Cancer Australia, Prostate Cancer Foundation of Australia, Cancer Council of Victoria, Cancer Council of South Australia, the Victorian Cancer Agency, Cancer Australia, Prostate Cancer Foundation of Australia, Asociación Española Contra el Cáncer (AECC), the Instituto de Salud Carlos III, Fondo Europeo de Desarrollo Regional (FEDER), the Institut Català de la Salut, Autonomous Government of Catalonia, Fundação para a Ciência e a Tecnologia, National Institutes of Health National Cancer Institute, Swedish Cancer Society, General Hospital in Malmö Foundation for Combating Cancer

Psychosocial impact of undergoing prostate cancer screening for men with BRCA1 or BRCA2 mutations.

OBJECTIVES: To report the baseline results of a longitudinal psychosocial study that forms part of the IMPACT study, a multi-national investigation of targeted prostate cancer (PCa) screening among men with a known pathogenic germline mutation in the BRCA1 or BRCA2 genes. PARTICPANTS AND METHODS: Men enrolled in the IMPACT study were invited to complete a questionnaire at collaborating sites prior to each annual screening visit. The questionnaire included sociodemographic characteristics and the following measures: the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), 36-item short-form health survey (SF-36), Memorial Anxiety Scale for Prostate Cancer, Cancer Worry Scale-Revised, risk perception and knowledge. The results of the baseline questionnaire are presented. RESULTS: A total of 432 men completed questionnaires: 98 and 160 had mutations in BRCA1 and BRCA2 genes, respectively, and 174 were controls (familial mutation negative). Participants' perception of PCa risk was influenced by genetic status. Knowledge levels were high and unrelated to genetic status. Mean scores for the HADS and SF-36 were within reported general population norms and mean IES scores were within normal range. IES mean intrusion and avoidance scores were significantly higher in BRCA1/BRCA2 carriers than in controls and were higher in men with increased PCa risk perception. At the multivariate level, risk perception contributed more significantly to variance in IES scores than genetic status. CONCLUSION: This is the first study to report the psychosocial profile of men with BRCA1/BRCA2 mutations undergoing PCa screening. No clinically concerning levels of general or cancer-specific distress or poor quality of life were detected in the cohort as a whole. A small subset of participants reported higher levels of distress, suggesting the need for healthcare professionals offering PCa screening to identify these risk factors and offer additional information and support to men seeking PCa screening

Introduction to Special Issue on “Divorce and the Life Course”

With the severe upswing in divorce experienced by developed nations in the last fifty years, social scientists in many disciplines are intensifying their focus on marital dissolution and its implications for society, families, and individuals [...

Epigenetic effects of cryopreservation and inbreeding in dairy cattle

It is well known that cryopreservation can lead to DNA damage and decreased sperm motility. Epigenetic changes/abnormalities have also recently been shown to be transgenerational. Certain advanced reproductive technologies can increase the risk of epigenetic abnormalities in the embryo, and preliminary data in our laboratory has shown that murine sperm cryopreservation can lead to changes in the expression of imprinted genes, with these changes possibly exacerbated in inbred strains. This is a potential problem for the Australian Dairy cattle industry, as inbreeding values are increasing yearly in several breeds, such as Australian Jersey cattle (Wiggans et al., 1997). The current research described here may be useful in promoting breeding strategies that minimize inbreeding by farmers. 6 inbred and 7 outbred bulls were evaluated. All fresh semen successfully passed quality control parameters established at Genetics Australia. Both fresh and frozen semen was used for in vitro fertilization and blastocyst rates recorded. In general, there was a higher percentage of blastocysts produced from frozen semen in outbred bulls (avg. 26.0%) than in inbred bulls (avg. fresh 21.3% and avg. frozen 20.9%). All blastocysts were frozen and gene expression analysis of these embryos is currently in progress by both microarray analysis and qPCR

The Effects of Family Characteristics and Time Use on Teenagers\u27 Household Labor

Studies suggest that children\u27s contributions to housework are minimal. However, much of this research focuses on young adolescents, utilizes data regarding adult tasks, and ignores chores children more often perform. We address these gaps by analyzing longitudinal time-use data collected from teens on the types of household chores they are most likely to perform. We examine gender inequity in teens\u27 contributions to household labor and how it changes over high school. We also explore how teens\u27 household contributions vary by family structure, and by teens\u27 involvement in school and paid work. We find that girls devote more time to household tasks than boys and that this gender gap increases during high school. Teens\u27 efforts are greater in larger families and in single parent families. Lastly, high school males spend more time on extracurricular and leisure activities than girls, who work longer hours in both unpaid and paid labor