Aging in Place: The Role of Public-Private Partnerships

Declining public resources necessitate collaboration between public and private investors in order to meet the demands of an aging society to ‘age in place.’ Aging in place is a term that has emerged in the past ten years to describe older people’s desire to stay in their home and community. This paper presents an overview of aging in place and the role of public-private partnerships in finding solutions. Examples illustrate the common elements of successful existing partnership models for future replication. Additional opportunities for innovation demonstrate that much more can be done to meet the needs of the aging population and honor their preference to age in place

The Lantern Vol. 24, No. 3, May 1956

• Wedding Week in East Pookins • Playground • When the Moon • Love Song • Balladier • Soliloquy • The Search for Alfie Patch • How I Learned to Drive • The Hard-Backed Chair • Amicus • A Strange Experiencehttps://digitalcommons.ursinus.edu/lantern/1069/thumbnail.jp

Sorption of organic gases in a furnished room

We present experimental data and semi-empirical models describing the sorption of organic gases in a simulated indoor residential environment. Two replicate experiments were conducted with 20 volatile organic compounds (VOCs) in a 50-m{sup 3} room finished with painted wallboard, carpet and cushion, draperies and furnishings. The VOCs span a wide volatility range and include ten Hazardous Air Pollutants. VOCs were introduced to the static chamber as a pulse and their gas-phase concentrations were measured during a net adsorption period and a subsequent net desorption period. Three sorption models were fit to the measured concentrations for each compound to determine the simplest formulation needed to adequately describe the observed behavior. Sorption parameter values were determined by fitting the models to adsorption period data then checked by comparing measured and predicted behavior during desorption. The adequacy of each model was evaluated using a goodness of fit parameter calculated for each period. Results indicate that sorption usually does not greatly affect indoor concentrations of methyl-tert-butyl ether, 2-butanone, isoprene and benzene. In contrast, sorption appears to be a relevant indoor process for many of the VOCs studied, including C{sub 8}-C{sub 10} aromatic hydrocarbons (HC), terpenes, and pyridine. These compounds sorbed at rates close to typical residential air change rates and exhibited substantial sorptive partitioning at equilibrium. Polycyclic aromatic HCs, aromatic alcohols, ethenylpyridine and nicotine initially adsorbed to surfaces at rates of 1.5 to >6 h{sup -1} and partitioned 95 to >99% in the sorbed phase at equilibrium

Reconsidering frameworks of Alzheimer’s dementia when assessing psychosocial outcomes

The purpose of this introductory article to the special issue on psychosocial outcome measures in Alzheimer’s & Dementia: Translational Research & Clinical Interventions is to outline new frameworks to more effectively capture and measure the full range of how people living with Alzheimer’s dementia and their family caregivers experience the disease process. Specifically, we consider the strengths and weaknesses of alternative perspectives, including person‐centered, strength‐based, and resilience‐focused approaches that may complement and extend the dominant deficit paradigm to reflect the entirety of the dementia experience. Our aim is to encourage innovative methods to measure psychosocial aspects of Alzheimer’s dementia and caregiving that have not yet received sufficient attention, including resources (e.g., services and supports) and positive caregiver and care recipient outcomes (e.g., positive mood and adaptation).Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152840/1/trc2jtrci201902008.pd

Home is where the future is: The BrightFocus Foundation consensus panel on dementia care

IntroductionA national consensus panel was convened to develop recommendations on future directions for home‐based dementia care (HBDC).MethodsThe panel summarized advantages and challenges of shifting to HBDC as the nexus of care and developed consensus‐based recommendations.ResultsThe panel developed five core recommendations: (1) HBDC should be considered the nexus of new dementia models, from diagnosis to end of life in dementia; (2) new payment models are needed to support HBDC and reward integration of care; (3) a diverse new workforce that spans the care continuum should be prepared urgently; (4) new technologies to promote communication, monitoring/safety, and symptoms management must be tested, integrated, and deployed; and (5) targeted dissemination efforts for HBDC must be employed.DiscussionHBDC represents a promising paradigm shift to improve care for those living with dementia and their family caregivers: these recommendations provide a framework to chart a course forward for HBDC.HighlightsFive core BrightFocus Foundation panel recommendations:Home‐based dementia care should be considered the nexus of new long‐term care models.New payment models are needed to stimulate, reward, and support home care practices.A skilled new workforce spanning long‐term care needs to be developed and equipped.New technologies to promote best practices must be tested, integrated, and deployed.Value propositions and improved public health communication are needed.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152597/1/alzjjalz201710006.pd

Evaluation of polygenic risk scores for breast and ovarian cancer risk prediction in BRCA1 and BRCA2 mutation carriers

Background: Genome-wide association studies (GWAS) have identified 94 common single-nucleotide polymorphisms (SNPs) associated with breast cancer (BC) risk and 18 associated with ovarian cancer (OC) risk. Several of these are also associated with risk of BC or OC for women who carry a pathogenic mutation in the high-risk BC and OC genes BRCA1 or BRCA2. The combined effects of these variants on BC or OC risk for BRCA1 and BRCA2 mutation carriers have not yet been assessed while their clinical management could benefit from improved personalized risk estimates. Methods: We constructed polygenic risk scores (PRS) using BC and OC susceptibility SNPs identified through population-based GWAS: for BC (overall, estrogen receptor [ER]-positive, and ER-negative) and for OC. Using data from 15 252 female BRCA1 and 8211 BRCA2 carriers, the association of each PRS with BC or OC risk was evaluated using a weighted cohort approach, with time to diagnosis as the outcome and estimation of the hazard ratios (HRs) per standard deviation increase in the PRS. Results: The PRS for ER-negative BC displayed the strongest association with BC risk in BRCA1 carriers (HR = 1.27, 95% confidence interval [CI] = 1.23 to 1.31, P = 8.2 x 10(53)). In BRCA2 carriers, the strongest association with BC risk was seen for the overall BC PRS (HR = 1.22, 95% CI = 1.17 to 1.28, P = 7.2 x 10(-20)). The OC PRS was strongly associated with OC risk for both BRCA1 and BRCA2 carriers. These translate to differences in absolute risks (more than 10% in each case) between the top and bottom deciles of the PRS distribution; for example, the OC risk was 6% by age 80 years for BRCA2 carriers at the 10th percentile of the OC PRS compared with 19% risk for those at the 90th percentile of PRS. Conclusions: BC and OC PRS are predictive of cancer risk in BRCA1 and BRCA2 carriers. Incorporation of the PRS into risk prediction models has promise to better inform decisions on cancer risk management