A Transcriptional Profile of Aging in the Human Kidney

In this study, we found 985 genes that change expression in the cortex and the medulla of the kidney with age. Some of the genes whose transcripts increase in abundance with age are known to be specifically expressed in immune cells, suggesting that immune surveillance or inflammation increases with age. The age-regulated genes show a similar aging profile in the cortex and the medulla, suggesting a common underlying mechanism for aging. Expression profiles of these age-regulated genes mark not only age, but also the relative health and physiology of the kidney in older individuals. Finally, the set of aging-regulated kidney genes suggests specific mechanisms and pathways that may play a role in kidney degeneration with age

Patient empowerment in long-term conditions: development and preliminary testing of a new measure

BACKGROUND: Patient empowerment is viewed by policy makers and health care practitioners as a mechanism to help patients with long-term conditions better manage their health and achieve better outcomes. However, assessing the role of empowerment is dependent on effective measures of empowerment. Although many measures of empowerment exist, no measure has been developed specifically for patients with long-term conditions in the primary care setting. This study presents preliminary data on the development and validation of such a measure. METHODS: We conducted two empirical studies. Study one was an interview study to understand empowerment from the perspective of patients living with long-term conditions. Qualitative analysis identified dimensions of empowerment, and the qualitative data were used to generate items relating to these dimensions. Study two was a cross-sectional postal study involving patients with different types of long-term conditions recruited from general practices. The survey was conducted to test and validate our new measure of empowerment. Factor analysis and regression were performed to test scale structure, internal consistency and construct validity. RESULTS: Sixteen predominately elderly patients with different types of long-term conditions described empowerment in terms of 5 dimensions (identity, knowledge and understanding, personal control, personal decision-making, and enabling other patients). One hundred and ninety seven survey responses were received from mainly older white females, with relatively low levels of formal education, with the majority retired from paid work. Almost half of the sample reported cardiovascular, joint or diabetes long-term conditions. Factor analysis identified a three factor solution (positive attitude and sense of control, knowledge and confidence in decision making and enabling others), although the structure lacked clarity. A total empowerment score across all items showed acceptable levels of internal consistency and relationships with other measures were generally supportive of its construct validity. CONCLUSION: Initial analyses suggest that the new empowerment measure meets basic psychometric criteria. Reasons concerning the failure to confirm the hypothesized factor structure are discussed alongside further developments of the scale

A test of community reassembly using the exotic communities of New Zealand roadsides in comparison to British roadsides

1 Competing theories of community assembly are very difficult to test. Four main theories exist. The Stochastic theory sees species assembly as being random. The Humpty Dumpty/Alternative Stable States (ASS) theory suggests that a community may be unable to reassemble itself from its constituent species. The Deterministic theory suggests there will be convergence to one stable state. The Pre-adaptation theory is similar to the Deterministic theory but emphasizes that many species fit the stable state because of characters acquired elsewhere. 2 The reassembly of a flora into new communities in a different country, or its assimilation as a major component of such communities, offers a means to test these theories. The invasion of British plant species into New Zealand, and their reassembly into roadside communities there, is a good example of such a natural experiment. 3 Plant communities of NZ roadsides were compared to the communities of the British National Vegetation Classification (NVC). British roadside communities were also compared to the NVC as a control. New Zealand roadside communities provided a fit to the NVC communities of only 54.7% on average. After excluding species that are not present in NZ, and therefore could not possibly reassemble, the fit increased to 61.1%. British roadsides gave a 65.8% fit. The NZ figures are similar to the fit obtained with random data (58.7%), indicating that the NZ communities bear little relation to the ones formed by the same species in Britain. 4 Similarity between roadside communities in NZ and Britain was low, forming two almost distinct sets of communities. 5 Some of the predictions of the Stochastic, Humpty Dumpty/ASS and Deterministic models are borne out, but others are not. It is concluded that British species have reassembled into communities in NZ most of which are new, i.e. distinct from those that occur in the native range of the species in Britain. The evidence points to a process of community assembly by pre-adaptation

Chronicity Index Increases with Age

<p>Shown is the chronicity index versus age for most of the kidney samples used in this study. The line shows the least squared fit through the data points.</p

Chronicity Index of Kidney Samples

<p>Histology from patient 40 is shown on the left, demonstrating a normal glomerulus (G), tubules and interstitial space (T), and arteriole (A), respectively (chronicity score of zero). Histology from patient 62 is shown on the right, demonstrating glomerulosclerosis (g), tubular atrophy and interstitial fibrosis (t), and arterial intimal hyalinosis (a), respectively (chronicity score of ten). Hematoxylin and eosin staining of paraffin-embedded sections.</p