Building better respite: hearing the voice of carers

Elaine Fielding, Elizabeth Beattie, Meredith Gresham, Christine Neville and Margaret Readford report on a study that investigated what carers of people with dementia want and need from respite services

Readers\u27 Speakout

Dear Editors: The article in the Summer 1980 Women\u27s Studies Newsletter (vol. 8, no. 3), Building Coalitions between Women\u27s Studies and Black Studies: What Are the Realities?, by Ann Cathey Carver, is to my mind excellent. The understanding by this professor of the very real social realities that make for problems between Women\u27s Studies and Black Studies—and between Black and white women—reflects a tremendous sensitivity which has obviously grown out of extended acquaintance with the Black experience. As a Black woman, concerned with both racism and sexism in the society, I think such perceptive analysis is invaluable. I hope that this piece will be read and understood by many, many others. On such a basis, it is possible to develop strong coalitions, stronger interrelationships and trust, and more intimate one-to-one relationships between faculty and students of both programs and between Black and white women

Innovative Technologies for Global Space Exploration

Under the direction of NASA's Exploration Systems Mission Directorate (ESMD), Directorate Integration Office (DIO), The Tauri Group with NASA's Technology Assessment and Integration Team (TAIT) completed several studies and white papers that identify novel technologies for human exploration. These studies provide technical inputs to space exploration roadmaps, identify potential organizations for exploration partnerships, and detail crosscutting technologies that may meet some of NASA's critical needs. These studies are supported by a relational database of more than 400 externally funded technologies relevant to current exploration challenges. The identified technologies can be integrated into existing and developing roadmaps to leverage external resources, thereby reducing the cost of space exploration. This approach to identifying potential spin-in technologies and partnerships could apply to other national space programs, as well as international and multi-government activities. This paper highlights innovative technologies and potential partnerships from economic sectors that historically are less connected to space exploration. It includes breakthrough concepts that could have a significant impact on space exploration and discusses the role of breakthrough concepts in technology planning. Technologies and partnerships are from NASA's Technology Horizons and Technology Frontiers game-changing and breakthrough technology reports as well as the External Government Technology Dataset, briefly described in the paper. The paper highlights example novel technologies that could be spun-in from government and commercial sources, including virtual worlds, synthetic biology, and human augmentation. It will consider how these technologies can impact space exploration and will discuss ongoing activities for planning and preparing them

Negotiating identities: ethnicity and social relations in a young offenders' institution

This article explores the situated nature of male prisoner identities in the late modern British context, using the contrasting theoretical frames of Sykes's (1958) indigenous model and Jacobs' (1979) importation model of prisoner subcultures and social relations. Drawing on eight months of ethnographic fieldwork in an ethnically, religiously and nationally diverse young offenders institution, consideration is given to how prisoners manage and negotiate difference, exploring the contours of racialization and racism which can operate in ambiguous and contradictory ways. Sociological understandings of identity, ethnicity, racialization and racism are used to inform a more empirically grounded theoretical criminology

Identification of a Rare Coding Variant in Complement 3 Associated with Age-related Macular Degeneration

Macular degeneration is a common cause of blindness in the elderly. To identify rare coding variants associated with a large increase in risk of age-related macular degeneration (AMD), we sequenced 2,335 cases and 789 controls in 10 candidate loci (57 genes). To increase power, we augmented our control set with ancestry-matched exome sequenced controls. An analysis of coding variation in 2,268 AMD cases and 2,268 ancestry matched controls revealed two large-effect rare variants; previously described R1210C in the CFH gene (fcase = 0.51%, fcontrol = 0.02%, OR = 23.11), and newly identified K155Q in the C3 gene (fcase = 1.06%, fcontrol = 0.39%, OR = 2.68). The variants suggest decreased inhibition of C3 by Factor H, resulting in increased activation of the alternative complement pathway, as a key component of disease biology

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570