Exploring wellbeing in older male farmers in Western Australia

In the context of an ageing population it has become increasingly important to identify the determinants of wellbeing in older adulthood. A review of the literature relevant to wellbeing and strengths relevant to older male farmers in Australia was conducted. This body of knowledge was identified to be sparse. Existing literature on farming primarily had a deficits focus, and only a small number of qualitative studies were specific to older male farmers. Four broad, overlapping areas representing the meaning of wellbeing were identified as potentially important: farming work; connectedness; the land; health and wellbeing. The inter-connected nature of farming life was identified as presenting a unique set of circumstances for ageing well. Specifically, it was suggested that maintaining self-integrity within farming life may be important. In light of the depth provided by qualitative studies into the lived experiences of older male farmers in the state of New South Wales, it was concluded that further research of this nature was required in other states of Australia. Researcher

Breaking Down Traditional Classroom Walls and Studying Spacesuits Abroad

The spacesuit curriculum under development by the Spacesuit Utilization of Innovative Technology Laboratory (S.U.I.T. Lab) in the Spaceflight Operations program of the Applied Aviation Sciences Department at Embry-Riddle Aeronautical University has the unique challenge of educating non-engineering students about extremely technical space systems, highlighted by spacesuits. CSO 399: “Spacesuits and Human Spaceflight Operations” course, taught in Greece each summer, introduces students to human spaceflight topics. This unique offering takes advantage of the clear water visibility in the Aegean Sea with practical underwater demonstrations of space operations. Students live in confined quarters on a sailboat for two weeks to simulate operations in a close-quarter space station, emulating astronaut living experiences. Hiking Mount Astráka in the Zagori region of Greece created an immersed environment to learn about spacewalk preparations for extravehicular activities. This course is innovative by taking students outside of the classroom to do hands-on, or gloveson, learning. Students taking this course have a drive to obtain a career in the spaceflight industry. By taking this course, students developed an understanding of the design process of human-rated spacecraft and spacesuits required to aid humans in exploring the cosmos. Nontraditional learning was reinforced by the uniqueness of the program teaching “anywhere but a classroom and included locales such as an amphitheater on the beach, catacombs, monasteries, a church courtyard, and as micro-lessons along the way, on sailboats, buses, hotels, and underwater. By changing the locations and having students constantly adapt to new learning environments they were able to grasp a feel for the constant changing pace of the space industry and the thrill of exploration

Why do some coronaviruses become pandemic threats when others do not?

Despite multiple spillover events and short chains of transmission on at least 4 continents, Middle East Respiratory Syndrome Coronavirus (MERS-CoV) has never triggered a pandemic. By contrast, its relative, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has, despite apparently little, if any, previous circulation in humans. Resolving the unsolved mystery of the failure of MERS-CoV to trigger a pandemic could help inform how we understand the pandemic potential of pathogens, and probing it underscores a need for a more holistic understanding of the ways in which viral genetic changes scale up to population-level transmission

Facilitators and barriers to post-discharge pain assessment and triage: a qualitative study of nurses\u27 and patients\u27 perspectives

BACKGROUND: After hospital discharge, patients can experience symptoms prompting them to seek acute medical attention. Early evaluation of patients\u27 post-discharge symptoms by healthcare providers may improve appropriate healthcare utilization and patient safety. Post-discharge follow-up phone calls, which are used for routine transitional care in U.S. hospitals, serve as an important channel for provider-patient communication about symptoms. This study aimed to assess the facilitators and barriers to evaluating and triaging pain symptoms in cardiovascular patients through follow-up phone calls after their discharge from a large healthcare system in Central Massachusetts. We also discuss strategies that may help address the identified barriers. METHODS: Guided by the Practical, Robust, Implementation and Sustainability Model (PRISM), we completed semi-structured interviews with 7 nurses and 16 patients in 2020. Selected nurses conducted (or supervised) post-discharge follow-up calls on behalf of 5 clinical teams (2 primary care; 3 cardiology). We used thematic analysis to identify themes from interviews and mapped them to the domains of the PRISM model. RESULTS: Participants described common facilitators and barriers related to the four domains of PRISM: Intervention (I), Recipients (R), Implementation and Sustainability Infrastructure (ISI), and External Environment (EE). Facilitators include: (1) patients being willing to receive provider follow-up (R); (2) nurses experienced in symptom assessment (R); (3) good care coordination within individual clinical teams (R); (4) electronic health record system and call templates to support follow-up calls (ISI); and (5) national and institutional policies to support post-discharge follow-up (EE). Barriers include: (1) limitations of conducting symptom assessment by provider-initiated follow-up calls (I); (2) difficulty connecting patients and providers in a timely manner (R); (3) suboptimal coordination for transitional care among primary care and cardiology providers (R); and (4) lack of emphasis on post-discharge follow-up call reimbursement among cardiology clinics (EE). Specific barriers for pain assessment include: (1) concerns with pain medication misuse (R); and (2) no standardized pain assessment and triage protocol (ISI). CONCLUSIONS: Strategies to empower patients, facilitate timely patient-provider communication, and support care coordination regarding pain evaluation and treatment may reduce the barriers and improve processes and outcomes of pain assessment and triage

Professional Standards for School-Based Behavior Analysts

The Professional Standards for School-Based Behavior Analysts are intended to serve as an enhanced foundational layer for behavior analysts working specifically in the context of public school settings. These Professional Standards were developed by a team of behavior analysts with experience working in public schools and feedback was obtained from additional behavior analysts and other education professionals. There are five identified Professional Standard areas including: 1) Ethical & Professional Practice; 2) Collaboration; 3) Systems Capacity Building; 4) Instruction; and 5) Leadership & Policy

Long-term AZT Exposure Alters the Metabolic Capacity of Cultured Human Lymphoblastoid Cells

The antiretroviral efficacy of 3′-azido-3′-deoxythymidine (AZT) is dependent upon intracellular mono-, di-, and triphosphorylation and incorporation into DNA in place of thymidine. Thymidine kinase 1 (TK-1) catalyzes the first step of this pathway. MOLT-3, human lymphoblastoid cells, were exposed to AZT continuously for 14 passages (P1–P14) and cultured for an additional 14 passages (P15–P28) without AZT. Progressive and irreversible depletion of the enzymatically active form of the TK-1 24-kDa monomer with loss of active protein was demonstrated during P1–P5 of AZT exposure. From P15 to P28, both the 24- and the 48-kDa forms of TK-1 were undetectable and a tetrameric 96-kDa form was present. AZT-DNA incorporation was observed with values of 150, 133, and 108 molecules of AZT/106 nucleotides at the 10μM plasma-equivalent AZT dose at P1, P5, and P14, respectively. An exposure-related increase in the frequency of micronuclei (MN) was observed in cells exposed to either 10 or 800μM AZT during P1–P14. Analysis of the cell cycle profile revealed an accumulation of S-phase cells and a decrease in G1-phase cells during exposure to 800μM AZT for 14 passages. When MOLT-3 cells were grown in AZT-free media (P15–P29), there was a reduction in AZT-DNA incorporation and MN formation; however, TK-1 depletion and the persistence of S-phase delay were unchanged. These data suggest that in addition to known mutagenic mechanisms, cells may become resistant to AZT partially through inactivation of TK-1 and through modulation of cell cycle components

Qualitative and quantitative evidence of motivation states for physical activity, exercise and being sedentary from university student focus groups

Motivation for physical activity and sedentary behaviors (e.g., desires, urges, wants, cravings) varies from moment to moment. According to the WANT model, these motivation states may be affectively-charged (e.g., felt as tension), particularly after periods of maximal exercise or extended rest. The purpose of this study was to examine postulates of the WANT model utilizing a mixed-methods approach. We hypothesized that: (1) qualitative evidence would emerge from interviews to support this model, and (2) motivation states would quantitatively change over the course of an interview period. Seventeen undergraduate students (mean age = 18.6y, 13 women) engaged in focus groups where 12 structured questions were presented. Participants completed the “right now” version of the CRAVE scale before and after interviews. Qualitative data were analyzed with content analysis. A total of 410 unique lower-order themes were classified and grouped into 43 higher order themes (HOTs). From HOTs, six super higher order themes (SHOTs) were designated: (1) wants and aversions, (2) change and stability, (3) autonomy and automaticity, (4) objectives and impulses, (5) restraining and propelling forces, and (6) stress and boredom. Participants stated that they experienced desires to move and rest, including during the interview, but these states changed rapidly and varied both randomly as well as systematically across periods of minutes to months. Some also described a total absence of desire or even aversion to move and rest. Of note, strong urges and cravings for movement, typically from conditions of deprivation (e.g., sudden withdrawal from exercise training) were associated with physical and mental manifestations, such as fidgeting and feeling restless. Urges were often consummated with behavior (e.g., exercise sessions, naps), which commonly resulted in satiation and subsequent drop in desire. Importantly, stress was frequently described as both an inhibitor and instigator of motivation states. CRAVE-Move increased pre-to-post interviews (p < .01). CRAVE-Rest demonstrated a trend to decline (p = .057). Overall, qualitative and quantitative data largely corroborated postulates of the WANT model, demonstrating that people experience wants and cravings to move and rest, and that these states appear to fluctuate significantly, especially in the context of stress, boredom, satiety, and deprivation

Getting the invite list right : a discussion of sepsis severity scoring systems in severe complicated intra-abdominal sepsis and randomized trial inclusion criteria

Background: Severe complicated intra-abdominal sepsis (SCIAS) is a worldwide challenge with increasing incidence. Open abdomen management with enhanced clearance of fluid and biomediators from the peritoneum is a potential therapy requiring prospective evaluation. Given the complexity of powering multi-center trials, it is essential to recruit an inception cohort sick enough to benefit from the intervention; otherwise, no effect of a potentially beneficial therapy may be apparent An evaluation of abilities of recognized predictive systems to recognize SCIAS patients was conducted using an existing intra-abdominal sepsis (IAS) database. Methods: All consecutive adult patients with a diffuse secondary peritonitis between 2012 and 2013 were collected from a quaternary care hospital in Finland, excluding appendicitis/cholecystitis. From this retrospectively collected database, a target population (93) of those with either ICU admission or mortality were selected. The performance metrics of the Third Consensus Definitions for Sepsis and Septic Shock based on both SOFA and quick SOFA, the World Society of Emergency Surgery Sepsis Severity Score (WSESSSS), the APACHE II score, Manheim Peritonitis Index (MPI), and the Calgary Predisposition, Infection, Response, and Organ dysfunction (CPIRO) score were all tested for their discriminant ability to identify this subgroup with SCIAS and to predict mortality. Results: Predictive systems with an area under-the-receiving-operating characteristic (AUQ curve >= 0.8 included SOFA, Sepsis-3 definitions, APACHE II, WSESSSS, and CPIRO scores with the overall best for CPIRO. The highest identification rates were SOFA score >= 2 (78.4%), followed by the WSESSSS score >= 8 (73.1%), SOFA >= 3 (752%), and APACHE II >= 14 (68.8%) identification. Combining the Sepsis-3 septic-shock definition and WSESSS >= 8 increased detection to 80%. Including CPIRO score >= 3 increased this to 82.8% (Sensitivity-SN; 83% Specificity-SP; 74%. Comparatively, SOFA >= 4 and WSESSSS >= 8 with or without septic-shock had 83.9% detection (SN; 84%, SP; 75%, 25% mortality). Conclusions: No one scoring system behaves perfectly, and all are largely dominated by organ dysfunction. Utilizing combinations of SOFA, CPIRO, and WSESSSS scores in addition to the Sepsis-3 septic shock definition appears to offer the widest "inclusion-criteria" to recognize patients with a high chance of mortality and ICU admission.Peer reviewe