Barriers and Solutions to Advance Care Planning among Homeless-Experienced Older Adults.

Background/Objectives: Older homeless-experienced adults have low rates of advance care planning (ACP) engagement despite high rates of morbidity and mortality. To inform intervention development, we examined potential barriers and solutions to ACP engagement. Design: Cross-sectional qualitative study. Setting: We recruited adults who were homeless in the prior three years and ≥50 years of age in the San Francisco Bay Area, and recruited clinical stakeholders from a national meeting of homeless providers. We analyzed qualitative data using thematic analysis. Measurements: We conducted semistructured interviews with homeless-experienced older adults (n = 20) and focus groups with clinical stakeholders (n = 24) about perceived barriers and solutions to ACP engagement. Results: Participants considered ACP important, reflecting on deaths of people in their networks who had died. Participant-identified barriers to ACP included poor ACP knowledge, lack of familial ties and social isolation, competing priorities, avoidance and lack of readiness, fatalism and mistrust, and lack of ACP training for clinical and nonclinical staff. They identified solutions that included framing ACP as a way to provide meaning and assert choice, providing easy-to-read written documents focused on the populations' unique needs, tailoring content and delivery, initiating ACP in nonclinical settings, such as permanent supportive housing, and providing incentives. Conclusions: Both older homeless-experienced adults and clinical stakeholders believe that ACP is important, but acknowledge multiple barriers that impede engagement. By focusing on potential solutions, including capitalizing on opportunities outside of health care settings, focusing on the period after housing, and tailoring content, there are opportunities to improve ACP uptake

Effects of experimental tail shortening on the phenotypic condition of barn swallows Hirundo rustica: Implications for tail-length evolution

Some studies have suggested that tail streamers in the barn swallow Hirundo rustica may have been elongated 10-12 mm by sexual selection, but according to other studies, the length of these feathers is at the aerodynamic optimum or very close to it. To shed light on this issue, outermost tail feathers were experimentally shortened in male and female barn swallows by 1, 11 or 21 mm. Changes in four physiological parameters commonly used to estimate phenotypic condition in birds (weight, erythrocyte sedimentation rate, blood leukocyte concentration and heterophil/lymphocyte ratio) were checked one month later. Health improved (blood leukocyte concentration decreased) in the group of birds with tails shortened by 11 mm (both males and females), but body condition deteriorated (weight decreased) compared to the other two experimental groups. There was no significant effect of tail-length manipulation on the other two physiological parameters. These contradictory results suggest trade-offs between components of phenotypic condition. Possible negative relationships between condition-related traits imply that using one or very few physiological parameters to estimate phenotypic condition might not be appropriate. The most plausible explanation for the turning point in phenotypic condition when streamers were shortened by 11 mm is that these feathers are 7-15 mm longer than the aerodynamic optimum in both sexes. Therefore, our results are consistent with the hypothesis that tail streamers have been elongated 10-12 mm by sexual selection. This conclusion disagrees with a previous study on the effect of experimental tail shortening on haematocrit, but the complexity of interpreting changes in haematocrit might account for this discrepancy. © 2014 The Authors.The study was funded by the Andalusian Regional Government (Acc. Coord. 2001) and by the Spanish Ministry of Science and Technology and the European Regional Development Fund (projects BOS2001-1717 and CGL2008-00137/BOS).Peer Reviewe

Reaching the millennium development goals : Mauritania should care

Mauritania is a resource-rich developing country. As many other African nations, it will not reach most of the Millennium Development Goals, unless the authorities commit to accelerating progress. To succeed by 2015, the government needs to: mobilize additional financial resources, introduce policy changes at the sector level, and strengthen the links between strategic objectives and the budget. Adopting the Millennium Development Goals as the overarching development framework will keep policy-makers focused on concrete results and help them avoid the so-called"natural resource curse."This paper calculates the total cost of the Millennium Development Goals and financing gap (on aggregate and for each goal); recommends changes in domestic sector policies; and proposes ways to integrate the Millennium Development Goals into the budget process. Over 2008-2015, the total cost of reaching the goals in Mauritania and the resulting financing gap stand at, respectively, around 9 and 3 percent of non-oil gross domestic product on average per year. Education is the most expensive goal in absolute terms, but the individual financing gaps are widest for poverty reduction and improving maternal health. On the policy side, sector strategies need to be aligned with the goals and resources allocated more than proportionally to the disadvantaged groups, mainly at the local level.Population Policies,Health Monitoring&Evaluation,Rural Poverty Reduction,Health Systems Development&Reform,

On the existence of supersolid helium-4 monolayer films

Extensive Monte Carlo simulations of helium-4 monolayer films adsorbed on weak substrates have been carried out, aimed at ascertaining the possible occurrence of a quasi-two-dimensional supersolid phase. Only crystalline films not registered with underlying substrates are considered. Numerical results yield strong evidence that helium-4 will not form a supersolid film on {any} substrate strong enough to stabilize a crystalline layer. On weaker substrates, continuous growth of a liquid film takes place

The Key Role Transferring Knowledge of Nuclear España, The Spanish Nuclear Society Magazine

The magazine of the Spanish Nuclear Society (SNE), “Nuclear España” is a scientific-technical publication with almost thirty years of uninterrupted edition and more than 300 numbers published. Their pages approach technical subjects related to the nuclear energy, as well as the activities developed by the SNE, especially in national and international meetings. The main part of the magazine is composed by articles written by known specialist of the energy industry. One of the top goals of the magazine is to help on transferring the knowledge from the generation that built the nuclear power plants in Spain and the new generation of professionals that have started its nuclear career in the last years. Each number is monographic, trying to cover as many aspects on an issue as it is possible, with collaborations from the companies, the research centers and universities that helps to have complementary points of view. On the other hand the articles help to deep in the issue´s topic, broadening the view of the readers about the nuclear field and helping to share knowledge across the industry. The news section of the Magazine picks up the actuality of the sector as a whole. The editorial section reflects the opinion of the SNE Governing Board and the Magazine Committee on the subjects of interest in this field. On the other hand, the monthly interview sets out the professional outstanding opinions. With a total of eleven numbers per year, three of them have a noticeable international character: the one dedicated to the operative experiences on the Spanish and European nuclear power plants, the monographic issue devoted tothe Annual Meeting of the SNE and the international issue, which covers the last activities of the Spanish industry in international projects. Both first are bilingual issues (Spanish-English), whereas the international edition is published completely in English. Besides its diffusion through all the members of the SNE, the Magazine is distributed, in the national scope, to companies and organisms related to the nuclear power, universities, research centers, representatives of the Central, Autonomic and Local Administrations, mass media and communication professionals. It is also sent to the utilities and research centers in Europe, United States, South America and Asia

Perinatal and parental determinants of childhood overweight in 6-12 years old children

Introduction & aims: The identification of determinants of childhood overweight is crucial to early diagnosis and prevention. The aim of this study was to assess perinatal and parental related risk factors concerning children for having excessive body weight. Methods: Cross-sectional study involving 3,101 children participating in the programme “Alimenta su salud” conducted in Castilla-La Mancha (Spain). Anthropometric and sociodemographic data were obtained from a general questionnaire. Analysed factors as potential predictors of childhood overweight were sex, age, birth weight, infant feeding, number of siblings, as well as parental marital status, educational level and obesity. Prevalence of overweight stratified by potential determinants was assessed. Univariate and multivariate logistic regression analyses were used to examine the associations between variables and the likelihood of being overweight. Results: The overweight prevalence (including obesity) was 30.3% in boys and 28.3% in girls, according to the IOTF criteria. Higher rates in younger subjects and some gender differences were observed. Parental obesity was the most important predictive variable for childhood overweight in both sexes and birth weight over 3,500 g in girls (OR 1.8, 95% CI 1.3-2.3). Having one or more siblings (OR 0.7, 95% CI 0.5-0.9) and higher paternal education (OR 0.8, 95% CI 0.6-0.9) in boys, and older age in girls (OR 0.7, 95% CI 0.5-.09), resulted protective factors against childhood overweight. No independent effects of marital status, maternal education and infant feeding patterns on childhood excess weight were identified. Conclusions: Perinatal and parental factors could contribute to predict the risk of being overweight/obese in children aged 6 to 12 years, which should be considered when formulating obesity prevention and intervention strategies, stressing the importance of targeting obese parents with young children

The logistic decision making in management accounting with genetic algoritms and fuzzy sets

The logistics problems in business environments deal with assignation from a number of sources to a number of destinations. Each source offers amounts of goods, while each destination demands quantities of these goods. The object is to find the cheapest transporting schedule that satisfies the demand without violating supply restraints. In this paper we propose to use Fuzzy Sets to represents the previsional information related to costs, demands and other variables. Moreover, we suggest including the problem of shortest route for the distribution vehicles. Finally, to solve this complex problem we propose to use a Genetic Algorithm with a Fuzzy Fitness Function

IKK phosphorylates Huntingtin and targets it for degradation by the proteasome and lysosome

Expansion of the polyglutamine repeat within the protein Huntingtin (Htt) causes Huntington's disease, a neurodegenerative disease associated with aging and the accumulation of mutant Htt in diseased neurons. Understanding the mechanisms that influence Htt cellular degradation may target treatments designed to activate mutant Htt clearance pathways. We find that Htt is phosphorylated by the inflammatory kinase IKK, enhancing its normal clearance by the proteasome and lysosome. Phosphorylation of Htt regulates additional post-translational modifications, including Htt ubiquitination, SUMOylation, and acetylation, and increases Htt nuclear localization, cleavage, and clearance mediated by lysosomal-associated membrane protein 2A and Hsc70. We propose that IKK activates mutant Htt clearance until an age-related loss of proteasome/lysosome function promotes accumulation of toxic post-translationally modified mutant Htt. Thus, IKK activation may modulate mutant Htt neurotoxicity depending on the cell's ability to degrade the modified species

Sexually Selected Egg Coloration in Spotless Starlings

It has been recently proposed that the blue-green coloration in eggs of many avian species may constitute a sexually selected female signal. Blue-green color intensity would reflect the physiological condition of females, and hence it might also affect the allocation of male parental care. In this study, we use three different experimental approaches to explore the importance of sexual selection on blue-green egg coloration of spotless starling (Sturnus unicolor) eggs. First, experimental deterioration of female body condition (by means of wing feather removal) negatively affected the intensity of blue-green egg coloration. Second, blue-green color intensity of artificial model eggs had a significant positive influence on paternal feeding effort. Finally, we found a negative relationship between the effect of experimental food supply on nestling immunocompetence and the intensity of blue-green coloration of eggs, suggesting that egg color predicts nutritional conditions that nestlings will experience during development. All these results taken together strongly support a role of sexual selection in the blue-green coloration of spotless starling eggs.This research was funded by the Spanish Ministry of Education and Science and the Fondo Europeo de Desarrollo Regional (FEDER; CGL2004-01777/BOS).Peer reviewe

Promoting tau secretion and propagation by hyperactive p300/CBP via autophagy-lysosomal pathway in tauopathy.

BackgroundThe trans-neuronal propagation of tau has been implicated in the progression of tau-mediated neurodegeneration. There is critical knowledge gap in understanding how tau is released and transmitted, and how that is dysregulated in diseases. Previously, we reported that lysine acetyltransferase p300/CBP acetylates tau and regulates its degradation and toxicity. However, whether p300/CBP is involved in regulation of tau secretion and propagation is unknown.MethodWe investigated the relationship between p300/CBP activity, the autophagy-lysosomal pathway (ALP) and tau secretion in mouse models of tauopathy and in cultured rodent and human neurons. Through a high-through-put compound screen, we identified a new p300 inhibitor that promotes autophagic flux and reduces tau secretion. Using fibril-induced tau spreading models in vitro and in vivo, we examined how p300/CBP regulates tau propagation.ResultsIncreased p300/CBP activity was associated with aberrant accumulation of ALP markers in a tau transgenic mouse model. p300/CBP hyperactivation blocked autophagic flux and increased tau secretion in neurons. Conversely, inhibiting p300/CBP promoted autophagic flux, reduced tau secretion, and reduced tau propagation in fibril-induced tau spreading models in vitro and in vivo.ConclusionsWe report that p300/CBP, a lysine acetyltransferase aberrantly activated in tauopathies, causes impairment in ALP, leading to excess tau secretion. This effect, together with increased intracellular tau accumulation, contributes to enhanced spreading of tau. Our findings suggest that inhibition of p300/CBP as a novel approach to correct ALP dysfunction and block disease progression in tauopathy