A systematic review of different models of home and community care services for older persons

<p>Abstract</p> <p>Background</p> <p>Costs and consumer preference have led to a shift from the long-term institutional care of aged older people to home and community based care. The aim of this review is to evaluate the outcomes of case managed, integrated or consumer directed home and community care services for older persons, including those with dementia.</p> <p>Methods</p> <p>A systematic review was conducted of non-medical home and community care services for frail older persons. MEDLINE, PsycINFO, CINAHL, AgeLine, Scopus and PubMed were searched from 1994 to May 2009. Two researchers independently reviewed search results.</p> <p>Results</p> <p>Thirty five papers were included in this review. Evidence from randomized controlled trials showed that case management improves function and appropriate use of medications, increases use of community services and reduces nursing home admission. Evidence, mostly from non-randomized trials, showed that integrated care increases service use; randomized trials reported that integrated care does not improve clinical outcomes. The lowest quality evidence was for consumer directed care which appears to increase satisfaction with care and community service use but has little effect on clinical outcomes. Studies were heterogeneous in methodology and results were not consistent.</p> <p>Conclusions</p> <p>The outcomes of each model of care differ and correspond to the model's focus. Combining key elements of all three models may maximize outcomes.</p

Nature of gold mineralisation in the Walhalla Goldfield, southeast Australia

The Walhalla-Woods Point Goldfield in southeast Australia is characterised by large gold deposits associated with a Late Devonian dyke swarm. The setting of this goldfield is unique because unlike the major gold deposits in Victoria, it occurs close to the eastern margin of the Western Lachlan Orogen, and highlights the disparities between the evolving phases of orogenic gold mineralisation in the Western Lachlan Orogen, and the contrasts between sediment hosted, dyke-associated and dyke-hosted gold mineralisation. This study integrates existing and new data from renewed mapping of the geology and geochemistry of three gold deposits near the township of Walhalla, in the historically important yet under-explored and under-researched Walhalla-Woods Point Goldfield. The ten highest yielding deposits within the goldfield are either hosted within, or adjacent to, intrusions of the Woods Point Dyke Swarm. This is due to the greater chemical reactivity of the calc-alkaline dykes, and the greater rheological contrast between the dykes and surrounding low-grade metasedimentary units, which allowed for the formation of dyke-hosted quartz breccia veins that are consistently favourable sites for gold mineralisation in the Walhalla Goldfield. This is in contrast to historical production, which concentrated on visible gold within the shear zone-hosted laminated quartz veins. Gold and As assay results have highlighted the increased levels of invisible gold disseminated along dyke margins in proximity to shear zones and quartz reefs. The high-yielding gold deposits hosted wholly by the dyke intrusions of the Woods Point Dyke Swarm are orogenic gold deposits, as they are not associated with elevated levels of Bi, W, As, Mb, Te and Sb, typical of intrusion-related gold deposits

Report (Battelle Memorial Institute. Columbus Laboratories)

Quarterly progress report on a project to test the radiation effects on metallurgy

Dysbiosis of fecal microbiota in cats with naturally occurring and experimentally induced Tritrichomonas foetus infection.

The protozoal pathogen Tritrichomonas foetus infects the colon of domestic cats and is a major cause of chronic colitis and diarrhea. Treatment failure is common, but antibiotics may improve clinical signs in a subset of cats, leading researchers to question involvement of the colonic microbiota in disease pathogenesis. Studies performed in women with venereal Trichomonas vaginalis infections have revealed that dysbiosis of host microbiota contributes to pathogenicity with similar findings also found in mice with intestinal Tritrichomonas musculis The aim of this study was to characterize differences in the fecal microbiota of cats with and without naturally occurring T. foetus infection and in a group of kittens prior to and after experimentally induced infection. Archived fecal DNA from cats undergoing testing for T. foetus infection (n = 89) and experimentally infected kittens (n = 4; at pre-, 2 weeks, and 9 weeks post-infection) were analyzed by sequencing of 16S rRNA genes. Amongst the naturally infected population, the genera Megamonas and Helicobacter were significantly increased in prevalence and abundance in cats testing positive for T. foetus infection. In the group of four experimentally infected kittens, fecal samples post-infection had significantly lower abundance of genus Dialister and Megamonas and greater abundance of the class Betaproteobacteria and family Succinivibrionaceae. We hypothesize that T. foetus promotes dysbiosis by competition for fermentable substrates used by these bacteria and that metabolic byproducts may contribute to the pathogenesis of colonic inflammation and diarrhea. Future studies are warranted for the measurement of fecal concentrations of microbial and protozoal metabolites in cats with T. foetus infection for the identification of potential therapeutic targets