Caring for the Caregiver: Incentivizing Medical Providers to Include Caregivers as Part of the Treatment Team

More than 1 in 5 people in the United States care for a family member, friend, or neighbor with a health care need or functional disability. More family caregivers find themselves caring for multiple people (24 percent) and working while caregiving (61 percent). Family caregivers face increasing complexity meeting the medical and support needs of their care recipients; 7 in 10 do so with no paid help. Without adequate and affordable services and supports, the escalating demands on family caregivers contribute to their physical, emotional, financial strain, and decline in self-reported health.In this white paper, published by The National Alliance for Caregiving, experts discuss incentives in the existing Medicare program that could motivate health systems and providers to offer more robust support to family caregivers.Click "Download" to access this resource

The Wave Properties of Coronal Bright Fronts Observed Using SDO/AIA

Coronal bright fronts (CBFs) are large scale wavefronts that propagate though the solar corona at hundreds of kilometers per second. While their kinematics have been studied in detail, many questions remain regarding the temporal evolution of their amplitude and pulse width. Here, contemporaneous high cadence, multi-thermal observations of the solar corona from the Solar Dynamic Observatory (SDO) and Solar TErrestrial RElations Observatory (STEREO) spacecraft are used to determine the kinematics and expansion rate of a CBF wavefront observed on 2010 August 14. The CBF was found to have a lower initial velocity with weaker deceleration in STEREO observations compared to SDO (~340 km/s and -72 m/s/s as opposed to ~410 km/s and -279 m/s/s). The CBF kinematics from SDO were found to be highly passband-dependent, with an initial velocity ranging from 379+/-12 km/s to 460+/-28 km/s and acceleration ranging from -128+/-28 m/s/s to -431+/-86 m/s/s in the 335A and 304A passbands respectively. These kinematics were used to estimate a quiet coronal magnetic field strength range of ~1-2 G. Significant pulse broadening was also observed, with expansion rates of ~130 km/s (STEREO) and ~220 km/s (SDO). By treating the CBF as a linear superposition of sinusoidal waves within a Gaussian envelope, the resulting dispersion rate of the pulse was found to be ~8-13 Mm^2 s^-1. These results are indicative of a fast-mode magnetoacoustic wave pulse propagating through an inhomogeneous medium.Comment: 14 pages, 2 figures. Accepted for publication in The Astrophysical Journal Letter

Mental Health in Diabetes Prevention and Intervention Programs in American Indian/Alaska Native Communities

American Indian and Alaska Natives youth and adults experience higher rates of type 2 diabetes and mental health problems than the general United States population. Few studies have explored the relationship other than detail the two issues independently. The present review aims to identify programs that seek to prevent/treat type 2 diabetes and mental health disorders in the American Indian and Alaska Native population. Available programs were reviewed for AI/AN adults and youth who suffer with both. As part of the review process, databases were searched for peer reviewed published studies. It was found that very few programs effectively incorporate mental health into the existing diabetes program. Four recommendations for future research are offered based on this literature review

Mental health in Diabetes Prevention and Intevention Programs in American Indian/Alaska Native Communities

American Indian and Alaska Natives youth and adults experience higher rates of type 2 diabetes and mental health problems than the general United States population. Few studies have explored the relationship other than detail the two issues independently. The present review aims to identify programs that seek to prevent/treat type 2 diabetes and mental health disorders in the American Indian and Alaska Native population. Available programs were reviewed for AI/AN adults and youth who suffer with both. As part of the review process, databases were searched for peer reviewed published studies. It was found that very few programs effectively incorporate mental health into the existing diabetes program. Four recommendations for future research are offered based on this literature review

On network modeling of manufacturing and related processes using GERT Summary report

Network modeling of manufacturing and related processes using Graphical Evaluation and Review Techniqu

Psychological Interventions for Dementia Caregivers:What We Have Achieved, What We Have Learned

With the rising dementia population, more and more programs have been developed to help caregivers deal with the care-recipient as well as their own frustrations. Many interventions aim to enhance caregiver’s ability to manage behavior problems and other deteriorations in functioning, with less direct emphasis placed on caring for the caregivers. We argue that techniques based on psychotherapy are strategically important in assistance provided to caregivers because of their utility for promoting emotional health. This article provides a focused review of such methods used in evidence-based intervention programs, along with the mechanisms of change associated with these methods. While cognitive-behavioral therapy (CBT) has a strong evidence base, there is also a growing trend to package CBT techniques into various psychoeducational programs. These programs, which we call psychoeducation with psychotherapeutic programs, have been consistently found to be effective in reducing caregiver distress and are suited for delivery in group format, even by paraprofessionals, to lower the cost of intervention. A recent trend is the effective use of technological aids (e.g., the internet) to deliver CBT and psychoeducation, reaching more caregivers. As for therapeutic mechanisms, use of coping skills, reduced dysfunctional thoughts, and increased self-efficacy in controlling upsetting thoughts have received support in studies. We conclude that psychotherapeutic techniques are increasingly being used effectively and efficiently to assist caregivers, aided by successful adaptation for educational or technologically advanced means of delivery. More research on therapeutic mechanisms is needed to understand how the techniques work and how they can be further refined

Super-Chandrasekhar SNe Ia Strongly Prefer Metal-Poor Environments

We discuss the emerging trend that super-Chandrasekhar Type Ia Supernovae (SCSNe) with progenitor mass estimates significantly exceeding 1.4 M_sun tend to explode in metal-poor environments. While Taubenberger et al. 2011 noted that some of the SCSNe host galaxies are relatively metal-poor, we focus quantitatively on their locations in the hosts to point out that in three out of four cases, the SCSNe explosions occurred in the outer edge of the disks of their hosts. It is therefore very likely that their progenitors had far lower metallicities than those implied by the metallicity of their hosts' central regions. In two cases (SN 2003fg and SN 2009dc) the explosion sites were outside 99% of the host's light, and in one case (SN 2006gz) the host's radial metallicity slope indicates that the explosion site is in a metal-poor region. The fourth case (SN 2007if) has the lowest spectroscopically measured SN Ia host metallicity (Childress et al. 2011. It may be possible to explain each of these unusually bright events through some progenitor scenario specific to that case, but a much simpler and straightforward conclusion would be to ascribe the controlling factor to the only physical aspect they have in common --- metal poor environments.Comment: 13 pages, 4 figures, 1 table. Accepted for publication in ApJ Letter

Cuticular colour reflects underlying architecture and is affected by a limiting resource

Central to the basis of ecological immunology are the ideas of costs and trade-offs between immunity and life history traits. As a physical barrier, the insect cuticle provides a key resistance trait, and Tenebrio molitor shows phenotypic variation in cuticular colour that correlates with resistance to the entomopathogenic fungus Metarhizium anisopliae. Here we first examined whether there is a relationship between cuticular colour variation and two aspects of cuticular architecture that we hypothesised may influence resistance to fungal invasion through the cuticle: its thickness and its porosity. Second, we tested the hypothesis that tyrosine, a semi-essential amino acid required for immune defence and cuticular melanisation and sclerotisation, can act as a limiting resource by supplementing the larval diet and subsequently examining adult cuticular colouration and thickness. We found that stock beetles and beetles artificially selected for extremes of cuticular colour had thicker less porous cuticles when they were darker, and thinner more porous cuticles when they were lighter, showing that colour co-varies with two architectural cuticular features. Experimental supplementation of the larval diet with tyrosine led to the development of darker adult cuticle and affected thickness in a sex-specific manner. However, it did not affect two immune traits. The results of this study provide a mechanism for maintenance of cuticular colour variation in this species of beetle; darker cuticles are thicker, but their production is potentially limited by resource constraints and differential investments in resistance mechanisms between the sexes