82 research outputs found

    What is the impact of policy differences on nursing home utilization?: the cases of Germany and the Netherlands

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    Though need factors would predict a higher rate of institutional use in Germany, in 2004 the percentage of people over 65 in institutions in the Netherlands was almost double the percentage in Germany. The lower nursing home utilization in Germany coincided with lower out-of-pocket costs, de facto means-testing of social assistance for such care, a lower perceived quality of nursing home, and less acceptance of the nursing home as a main care modality for adults experiencing functional impairments. These factors have developed over time and are consistent with a–relatively - large government responsibility toward care for the elderly and a preference for institutional care over home care in the Netherlands. The policy to encourage older adults to move to elderly homes to decrease the housing shortage after WWII might have had long-lasting effects. This paper points out that a key in the success of a reform is a behavioral change in the system. As there seems to be no single factor to decrease the percentage of older adults in nursing homes, a sequence of policies might be a more promising route

    Development of an Emotion-Sensitive mHealth Approach for Mood-State Recognition in Bipolar Disorder

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    Internet- and mobile-based approaches have become increasingly significant to psychological research in the field of bipolar disorders. While research suggests that emotional aspects of bipolar disorders are substantially related to the social and global functioning or the suicidality of patients, these aspects have so far not sufficiently been considered within the context of mobile-based disease management approaches. As a multiprofessional research team, we have developed a new and emotion-sensitive assistance system, which we have adapted to the needs of patients with bipolar disorder. Next to the analysis of self-assessments, third-party assessments, and sensor data, the new assistance system analyzes audio and video data of these patients regarding their emotional content or the presence of emotional cues. In this viewpoint, we describe the theoretical and technological basis of our emotion-sensitive approach and do not present empirical data or a proof of concept. To our knowledge, the new assistance system incorporates the first mobile-based approach to analyze emotional expressions of patients with bipolar disorder. As a next step, the validity and feasibility of our emotion-sensitive approach must be evaluated. In the future, it might benefit diagnostic, prognostic, or even therapeutic purposes and complement existing systems with the help of new and intuitive interaction models

    A new Heterodontosaurus specimen elucidates the unique ventilatory macroevolution of ornithischian dinosaurs

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    Ornithischian dinosaurs were ecologically prominent herbivores of the Mesozoic Era that achieved a global distribution by the onset of the Cretaceous. The ornithischian body plan is aberrant relative to other ornithodiran clades, and crucial details of their early evolution remain obscure. We present a new, fully articulated skeleton of the early branching ornithischian Heterodontosaurus tucki. Phase-contrast enhanced synchrotron data of this new specimen reveal a suite of novel postcranial features unknown in any other ornithischian, with implications for the early evolution of the group. These features include a large, anteriorly projecting sternum; bizarre, paddle-shaped sternal ribs; and a full gastral basket – the first recovered in Ornithischia. These unusual anatomical traits provide key information on the evolution of the ornithischian body plan and suggest functional shifts in the ventilatory apparatus occurred close to the base of the clade. We complement these anatomical data with a quantitative analysis of ornithischian pelvic architecture, which allows us to make a specific, stepwise hypothesis for their ventilatory evolution

    Volcanic impacts on peatland microbial communities: A tephropalaeoecological hypothesis-test

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    Volcanic eruptions affect peatlands around the world, depositing volcanic ash (tephra) and a variety of chemicals including compounds of sulphur. These volcanic impacts may be important for many reasons, in particular sulphur deposition has been shown to suppress peatland methane flux, potentially reinforcing climatic cooling. Experiments have shown that sulphur deposition also forces changes in testate amoeba communities, potentially relating to the reduced methane flux. Large volcanic eruptions in regions with extensive peatlands are relatively rare so it is difficult to assess the extent to which volcanic eruptions affect peatland microbial communities; palaeoecological analyses across tephra layers provide a means to resolve this uncertainty. In this study, testate amoebae were analysed across multiple monoliths from a peatland in southern Alaska containing two tephras, probably representing the 1883 eruption of Augustine Volcano and a 20th Century eruption of Redoubt Volcano. Results showed relatively distinct and often statistically significant changes in testate amoeba community coincident with tephra layers which largely matched the response found in experimental studies of sulphur deposition. The results suggest volcanic impacts on peatland microbial communities which might relate to changes in methane flux

    El asiento de avería y el origen de la compañía privilegiada en España

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    El presente artículo analiza cómo la autonomía patrimonial del capital destinado a la organización de las flotas con América acabó adquiriendo la forma de una verdadera compañía privilegiada de comercio, antecedente directo de la actual sociedad anónima, cuando la Corona dejó por entero a los particulares la administración de la avería a través del sistema de asientos. Los paralelismos de los asientos con las compañías llegaron a ser tan grandes que los funcionarios a quienes el conde-duque de Olivares encomendó el estudio de las compañías extranjeras, con objeto de introducirlas en España, vieron en los asientos una verdadera compañía privilegiada.This paper analyses how the progressive autonomy of the capital used to arrange the treasure fleets from Seville to America derived in a real chartered company, a precedent of today’s joint-stock company, when the Crown finally privatised it through the asientos de avería. The parallelism among the asientos and the companies were so noticeable that the public officers appointed by the Count-Duke of Olivares to study the foreign companies couldn’t detect any difference between both institutions.Publicad

    Optimal fetal growth for the Caucasian singleton and assessment of appropriateness of fetal growth: an analysis of a total population perinatal database

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    BACKGROUND: The appropriateness of an individual's intra uterine growth is now considered an important determinant of both short and long term outcomes, yet currently used measures have several shortcomings. This study demonstrates a method of assessing appropriateness of intrauterine growth based on the estimation of each individual's optimal newborn dimensions from routinely available perinatal data. Appropriateness of growth can then be inferred from the ratio of the value of the observed dimension to that of the optimal dimension. METHODS: Fractional polynomial regression models including terms for non-pathological determinants of fetal size (gestational duration, fetal gender and maternal height, age and parity) were used to predict birth weight, birth length and head circumference from a population without any major risk factors for sub-optimal intra-uterine growth. This population was selected from a total population of all singleton, Caucasian births in Western Australia 1998–2002. Births were excluded if the pregnancy was exposed to factors known to influence fetal growth pathologically. The values predicted by these models were treated as the optimal values, given infant gender, gestational age, maternal height, parity, and age. RESULTS: The selected sample (N = 62,746) comprised 60.5% of the total Caucasian singleton birth cohort. Equations are presented that predict optimal birth weight, birth length and head circumference given gestational duration, fetal gender, maternal height, age and parity. The best fitting models explained 40.5% of variance for birth weight, 32.2% for birth length, and 25.2% for head circumference at birth. CONCLUSION: Proportion of optimal birth weight (length or head circumference) provides a method of assessing appropriateness of intrauterine growth that is less dependent on the health of the reference population or the quality of their morphometric data than is percentile position on a birth weight distribution

    PABPN1 gene therapy for oculopharyngeal muscular dystrophy

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    International audienceOculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant, late-onset muscle disorder characterized by ptosis, swallowing difficulties, proximal limb weakness and nuclear aggregates in skeletal muscles. OPMD is caused by a trinucleotide repeat expansion in the PABPN1 gene that results in an N-terminal expanded polyalanine tract in polyA-binding protein nuclear 1 (PABPN1). Here we show that the treatment of a mouse model of OPMD with an adeno-associated virus-based gene therapy combining complete knockdown of endogenous PABPN1 and its replacement by a wild-type PABPN1 substantially reduces the amount of insoluble aggregates, decreases muscle fibrosis, reverts muscle strength to the level of healthy muscles and normalizes the muscle transcriptome. The efficacy of the combined treatment is further confirmed in cells derived from OPMD patients. These results pave the way towards a gene replacement approach for OPMD treatment

    Report on the sixth blind test of organic crystal-structure prediction methods

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    The sixth blind test of organic crystal-structure prediction (CSP) methods has been held, with five target systems: a small nearly rigid molecule, a polymorphic former drug candidate, a chloride salt hydrate, a co-crystal, and a bulky flexible molecule. This blind test has seen substantial growth in the number of submissions, with the broad range of prediction methods giving a unique insight into the state of the art in the field. Significant progress has been seen in treating flexible molecules, usage of hierarchical approaches to ranking structures, the application of density-functional approximations, and the establishment of new workflows and "best practices" for performing CSP calculations. All of the targets, apart from a single potentially disordered Z` = 2 polymorph of the drug candidate, were predicted by at least one submission. Despite many remaining challenges, it is clear that CSP methods are becoming more applicable to a wider range of real systems, including salts, hydrates and larger flexible molecules. The results also highlight the potential for CSP calculations to complement and augment experimental studies of organic solid forms
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