The AdHOC study of older adults’ adherence to medication in 11 countries

BACKGROUND: Compared with the resources expended developing, evaluating and making clinical decisions about prescribing medication, we know little about what determines whether people take it. Older adults are prescribed more medication than any other group. Poor adherence is a common reason for nonresponse to medication. OBJECTIVES: To investigate cross-nationally the impact of demographic, psychiatric (including cognitive), physical health, behavioural and medication factors on adherence to medication in older adults. METHODS: Researchers interviewed 3881 people over 65 who receive home care services using a structured interview at participants’ places of residence in eleven countries. The main outcome measure was the percentage participants not adherent to medication. RESULTS: 12.5% (n= 456) of people reported they were not fully adherent to medication. Non-adherence was predicted by problem drinking (OR=3.6), not having a doctor review medication (OR=3.3), dementia (OR=1.4 for every one point increase in impairment), good physical health (OR=1.2), resisting care (OR=2.1) being married (OR=2.3) and living in the Czech Republic (OR=4.7) or Germany (OR=1.4). CONCLUSION: People, who screen positive for problem drinking and with dementia, often undiagnosed are less likely to adhere to medication. Therefore doctors should consider dementia and problem drinking when prescribing for older adults. Interventions to improve adherence in older adults might be more effective if 4 targeted at these groups. It is possible that medication review enhances adherence, by improving the patient-doctor relationship, or by emphasising the relevance of medications

The Association Between Impaired Awareness and Depression, Anxiety, and Apathy in Mild to Moderate Alzheimer's Disease: A Systematic Review

Objectives: Impaired awareness of cognitive and functional deficits is a common feature of Alzheimer's disease (AD). Although a lack of awareness has been suggested to be a protective factor against experiencing affective symptoms, such as depression, anxiety, and apathy which are common in AD, there is conflicting evidence about the links between them. This systematic review examines the evidence for an association between impaired awareness and depressive, anxiety, and apathy symptoms in mild to moderate AD. / Method: We searched four databases (OvidMedline, Embase, PsycInfo, and PsycArticles) using terms encompassing awareness, apathy, depression, anxiety, and mild-moderate AD. We included studies that assessed the relationship between awareness and depressive symptoms, anxiety symptoms, or apathy. We assessed included papers for quality and report results using a narrative approach, prioritizing high quality studies. / Results: We identified 1,544 articles, and twenty-seven studies fulfilled inclusion criteria (high-quality = 15; moderate-quality = 12). Most high-quality studies reported that impaired awareness in early-stage AD is cross-sectionally linked with fewer depressive symptoms and anxiety symptoms (correlation ranged from −0.3 to −0.7), but with more apathy. / Conclusions: High-quality studies suggested that in people with early AD, impaired awareness is related to fewer depressive and anxiety symptoms and to more apathy. Future research should focus on elucidating causality among impaired awareness and these symptoms in AD

Peter Van Brugh Livingston to Susan Kean, April 16, 1789

Peter Van Brugh Livingston wrote from Elizabethtown to Susan Kean, his daughter, addressed to Beaufort, SC. He is glad to hear she, John Kean, and their son Peter Kean are doing well. He had a visit from Susan\u27s brother, presumably Philip Livingston, on his way from Albany to Amboy. He mentioned that the family had lost a lot of assets during the Revolutionary War. Peggy Bayard, Eliza Bayard, Robert Livingston, Sarah Ricketts, Eliza Otto, and Mrs. Lhttps://digitalcommons.kean.edu/lhc_1780s/1059/thumbnail.jp

Peter Van Brugh Livingston with Robert Eoff, January 27, 1786

Indenture between Peter Van Brugh Livingston and Robert Eoff. Peter leased Robert 179.5 acres of land in the County of Somerset, NJ for six years. The indenture was witnessed by James Ricketts, Peter\u27s son-in-law, and John McDonald.https://digitalcommons.kean.edu/lhc_1780s/1072/thumbnail.jp

Peter Van Brugh Livingston to Susan Kean, January 16, 1789

Peter Van Brugh Livingston wrote from Abyssinia to Susan Kean, his daughter, addressed to Beaufort, SC. He was happy to hear of her, John Kean, and Peter Kean\u27s safe arrival in Charleston from New York.His wife, Elizabeth Livingston had been ill and he had not left the house since Christmas. He also remarked that he was in debt to Dr. Ramsey for his attention to Susan when she gave birth to Peter.https://digitalcommons.kean.edu/lhc_1780s/1057/thumbnail.jp

A Comparative Study of Magnetic Fields in the Solar Photosphere and Chromosphere at Equatorial and Polar Latitudes

Besides their own intrinsic interest, correct interpretation of solar surface magnetic field observations is crucial to our ability to describe the global magnetic structure of the solar atmosphere. Photospheric magnetograms are often used as lower boundary conditions in models of the corona, but not data from the nearly force-free chromosphere. National Solar Observatory's (NSO) Synoptic Optical Long-term Investigations of the Sun VSM (Vector Spectromagnetograph) produces full-disk line-of-sight magnetic flux images deriving from both photospheric and chromospheric layers on a daily basis. In this paper, we investigate key properties of the magnetic field in these two layers using more than five years of VSM data. We find from near-equatorial measurements that the east-west inclination angle of most photospheric fields is less than about 12{\deg}, while chromospheric fields expand in all directions to a significant degree. Using a simple stereoscopic inversion, we find evidence that photospheric polar fields are also nearly radial but that during 2008 the chromospheric field in the south pole was expanding superradially. We obtain a spatially resolved polar photospheric flux distribution up to 80{\deg} latitude whose strength increases poleward approximately as cosine(colatitude) to the power 9-10. This distribution would give a polar field strength of 5-6 G. We briefly discuss implications for future synoptic map construction and modeling

Quantum Fluctuations in the Chirped Pendulum

An anharmonic oscillator when driven with a fast, frequency chirped voltage pulse can oscillate with either small or large amplitude depending on whether the drive voltage is below or above a critical value-a well studied classical phenomenon known as autoresonance. Using a 6 GHz superconducting resonator embedded with a Josephson tunnel junction, we have studied for the first time the role of noise in this non-equilibrium system and find that the width of the threshold for capture into autoresonance decreases as the square root of T, and saturates below 150 mK due to zero point motion of the oscillator. This unique scaling results from the non-equilibrium excitation where fluctuations, both quantum and classical, only determine the initial oscillator motion and not its subsequent dynamics. We have investigated this paradigm in an electrical circuit but our findings are applicable to all out of equilibrium nonlinear oscillators.Comment: 5 pages, 4 figure