The role of sexual orientation, age, living arrangements and self-rated health in planning for end-of-life care for lesbian, gay and bisexual (LGB) older people in the UK

© The Author(s) 2020. The final, definitive version of this paper has been published in Sexualities by Sage Publications Ltd. All rights reserved. It is available at: https://doi.org/10.1177/1363460720932381.This article reports on findings from the quantitative phase of a two-year research project designed to explore end-of-life care experiences and needs of lesbian, gay, bisexual and transgender people. We draw on a subset of the sample (N = 180/237) to analyse the relationship between advance care planning, sexual orientation, living arrangements and self-rated health. The results contribute to a growing body of evidence on how sexual minorities approach and make decisions on advance care planning. A greater understanding of such patterns could help inform the way healthcare professionals engage in conversations about end-of-life care planning with older LGB people.Peer reviewe

The State of Theory in LGBTQ Aging: Implications for Gerontological Scholarship

Social research in lesbian, gay, bisexual, transgender, and queer (LGBTQ) aging is a rapidly growing field, but an examination of the use of theory has not yet been conducted for its impact on the field’s direction. We conducted a systematic review of empirical articles published in LGBTQ aging in the years 2009–2017 (N = 102). Using a typology of theory use in scholarly articles, we analyzed these articles for the types of theories being used, the degree to which theories were used in each article, and the analytical function they served. We found that 52% of articles consistently applied theory, 23% implied or partially applied theory, and 25% presented as atheoretical. A wide range of theories were used and served multiple analytical functions such as concept development and explanation of findings. We discuss the strengths and weaknesses of theory use in this body of literature, especially with respect to implications for future knowledge development in the field

Temperature variability implies greater economic damages from climate change

A number of influential assessments of the economic cost of climate change rely on just a small number of coupled climate–economy models. A central feature of these assessments is their accounting of the economic cost of epistemic uncertainty—that part of our uncertainty stemming from our inability to precisely estimate key model parameters, such as the Equilibrium Climate Sensitivity. However, these models fail to account for the cost of aleatory uncertainty—the irreducible uncertainty that remains even when the true parameter values are known. We show how to account for this second source of uncertainty in a physically well-founded and tractable way, and we demonstrate that even modest variability implies trillions of dollars of previously unaccounted for economic damages

日本語における語認識と平板型アクセント

博士（文学）神戸大

Accounting Problems Under the Excess Profits Tax

DNA vaccines based on subunits from pathogens have several advantages over other vaccine strategies. DNA vaccines can easily be modified, they show good safety profiles, are stable and inexpensive to produce, and the immune response can be focused to the antigen of interest. However, the immunogenicity of DNA vaccines which is generally quite low needs to be improved. Electroporation and co-delivery of genetically encoded immune adjuvants are two strategies aiming at increasing the efficacy of DNA vaccines. Here, we have examined whether targeting to antigen-presenting cells (APC) could increase the immune response to surface envelope glycoprotein (Env) gp120 from Human Immunodeficiency Virus type 1 (HIV- 1). To target APC, we utilized a homodimeric vaccine format denoted vaccibody, which enables covalent fusion of gp120 to molecules that can target APC. Two molecules were tested for their efficiency as targeting units: the antibody-derived single chain Fragment variable (scFv) specific for the major histocompatilibility complex (MHC) class II I-E molecules, and the CC chemokine ligand 3 (CCL3). The vaccines were delivered as DNA into muscle of mice with or without electroporation. Targeting of gp120 to MHC class II molecules induced antibodies that neutralized HIV-1 and that persisted for more than a year after one single immunization with electroporation. Targeting by CCL3 significantly increased the number of HIV-1 gp120-reactive CD8(+) T cells compared to non-targeted vaccines and gp120 delivered alone in the absence of electroporation. The data suggest that chemokines are promising molecular adjuvants because small amounts can attract immune cells and promote immune responses without advanced equipment such as electroporation.Funding Agencies|Research Council of Norway; Odd Fellow</p

The bodily presence of significant others: Intensive care patients' experiences in a situation of critical illness

This study is about intensive care patients and the bodily presence of significant others. The aim of the study is to inquire and understand the patients experience of the body in relation to their significant others during critical illness. Open, unstructured, in-depth interviews with six former intensive care patients provide the data for the study. The phenomenological–hermeneutical analysis points to a theme among ICU patients' experience of conflict between proximity and distance during the bodily presence of their relations. Patients experience different and conflicting forms of responses to the presence of their significant others. Patients experience significant positive confirmation but also negation through this presence. In the ICU situation, the reactions of significant others appear difficult to deal with, yet the physical presence is significant for establishing a sense of affinity. Patients seek to take some responsibility for themselves as well as for their relatives, and are met with a whole spectrum of reactions. Intensive care patients experience the need to be actively, physically present, which often creates sharp opposition between their personal needs and the needs of their significant others for active participation

Towards comprehensive syntactic and semantic annotations of the clinical narrative

Objective: To create annotated clinical narratives with layers of syntactic and semantic labels to facilitate advances in clinical natural language processing (NLP). To develop NLP algorithms and open source components. Methods: Manual annotation of a clinical narrative corpus of 127 606 tokens following the Treebank schema for syntactic information, PropBank schema for predicate-argument structures, and the Unified Medical Language System (UMLS) schema for semantic information. NLP components were developed. Results: The final corpus consists of 13 091 sentences containing 1772 distinct predicate lemmas. Of the 766 newly created PropBank frames, 74 are verbs. There are 28 539 named entity (NE) annotations spread over 15 UMLS semantic groups, one UMLS semantic type, and the Person semantic category. The most frequent annotations belong to the UMLS semantic groups of Procedures (15.71%), Disorders (14.74%), Concepts and Ideas (15.10%), Anatomy (12.80%), Chemicals and Drugs (7.49%), and the UMLS semantic type of Sign or Symptom (12.46%). Inter-annotator agreement results: Treebank (0.926), PropBank (0.891–0.931), NE (0.697–0.750). The part-of-speech tagger, constituency parser, dependency parser, and semantic role labeler are built from the corpus and released open source. A significant limitation uncovered by this project is the need for the NLP community to develop a widely agreed-upon schema for the annotation of clinical concepts and their relations. Conclusions: This project takes a foundational step towards bringing the field of clinical NLP up to par with NLP in the general domain. The corpus creation and NLP components provide a resource for research and application development that would have been previously impossible

Suicidal Thoughts and Behaviors Among Transgender Adults in Relation to Education, Ethnicity, and Income: A Systematic Review

Introduction: This systematic review assessed the impact of race/ethnicity, education, and income on transgender individual's lifetime experience of suicidal thoughts and behaviors (SITB) in gray and published literature (1997–2017). Methods: Sixty four research projects (108 articles) were identified in WorldCat, PubMed, and Google Scholar. Articles were included if they were published in Canada or the United States, included original quantifiable data on transgender SITBs, and had ≥5 participants, at least 51% of whom were ≥18 years. Results: Across all projects suicide ideation averaged 46.55% and attempts averaged 27.19%. The majority of participants were Caucasian, whereas the highest rate of suicide attempts (55.31%) was among First Nations, who accounted for <1.5% of participants. Caucasians, by contrast, had the lowest attempt rate (36.80%). More participants obtained a bachelor's degree and fewer an associate or technical degree than any other level of education. Suicide attempts were highest among those with ≤some high school (50.70%) and lowest among those with an advanced degree (30.25%). More participants made an income of $20–$50,000/year and less $10–$20,000 than any other income bracket. Conclusion: SITBs, among the transgender population, are both universally high and impacted by race/ethnicity, educational attainment, and income. These findings may be useful in creating culturally and factually informed interventions for transgender individuals experiencing SITBs and in informing future research on this topic

Relative performance of machine learning and linear regression in predicting quality of life and academic performance of school children in Norway : data analysis of a quasi-experimental study

Background: Machine learning (ML) approaches are increasingly being used in health research. It is not clear how useful these approaches are for modelling continuous health outcomes. Child quality of life (QoL) is associated with parental socioeconomic status and child activity levels, and may be associated with aerobic fitness and strength. It is not clear whether diet, or academic performance (AP) is associated with QoL. Objective: To compare predictive performances of ML approaches with linear regression for modelling QoL and AP using parental education and lifestyle data. Methods: We modelled data from children attending nine schools in a quasi-experimental study (NCT02495714). We split data randomly into training and validation sets, and simulated curvilinear, non-linear, and heteroscedastic variables. We examined relative performance of ML approaches using R2, making comparisons to mixed and fixed models, and regression with splines, with and without imputation. We also examined the effect of training set size on overfitting. Results: We had 1,711 cases. Using real data, our regression models explained 24% of AP variance in the complete-case validation set, and up to 15% of QoL variance. While ML models explained high proportions of variance in training sets, in validation sets these explained ~0% of AP and between 3% and 8% of QoL. Following imputation, ML models improved up to 15% for AP. ML models outperformed regression for modelling simulated non-linear and heteroscedastic variables only. A smaller training set did not lead to increased overfitting. The best predictors of QoL were 7-point self-reported activity (P<.001; ß=1.09 (95% CI 0.53 to 1.66)) and TV/computer use (P=.002; ß=-0.95 (-1.55 to -0.36)). For AP, these were mother having master’s-level education (P<.001; ß=1.98 (0.25 to 3.71)) and dichotomised self-reported activity (P=.001; ß=2.47 (1.08 to 3.87)). Adjusted academic performance was associated with QoL (P=.02; ß=0.12 (0.02 to 0.22)). Conclusions: Exercising to cause sweat once per week and 2 hours per day of TV or computer use are associated with small-to-medium increases and decreases in child QoL, respectively. An increase in AP of 20 units is associated with a small increase in QoL. A mother having higher and master’s-level education, 2 hours per day of TV or computer use, and taking at least 2 hours of exercise, are each associated with small-to-medium increases in AP. Differences between effects of computer/TV use for work/leisure needs further investigation. Linear regression is less prone to overfitting and performs better than ML in predicting continuous health outcomes in a dataset containing missing data. Imputation improves ML performance but not enough to outperform regression. ML outperformed regression with non-linear and heteroscedastic data and may be of use when such relationships exist, and where imputation is sensible or there are no missing data. Clinical Trial: The data are from a quasi-experimental design and not an RCT but nevertheless the study from which the data are from does have a registration: NCT0249571