Hospital to home : family caregiver perspectives of discharge transitions of seniors with dementia

Hospital discharge transitions can be challenging for seniors and their caregivers. Seniors with dementia are particularly vulnerable and are at increased risk for adverse outcomes from poorly executed hospital to home discharge transitions. Family caregivers play a vital role in supporting seniors with dementia by coordinating care among healthcare providers across the continuum of care. Research suggests there is significant opportunity for improvement in hospital discharge processes to ensure that patients with dementia and their family caregivers are prepared to resume care at home after hospital discharge. Family caregivers of hospitalized patients with dementia continue to report unmet needs and the extent to hospital discharge interventions are provided and how they are perceived by family caregivers of patients with dementia is unknown. Guided by Meleis’ middle-range theory of transitions, a critical incident technique study was designed to explore family caregiver perceptions of the hospital discharge process for seniors with dementia. Five categories of healthcare provider activities were identified as important to the hospital discharge process for persons with dementia. Providing person-centered dementia care involved recognizing dementia in the patient and the importance of taking a different approach. Getting on the same page emphasized the crucial role of communication and involved seeing a capable person and knowing the plan. Caregivers expressed concern for Maximizing function and strong enough to go home. Managing medications was critical to ensure behavioral symptoms of dementia were well managed. Post-discharge support involved getting needed information, arranging for services after discharge, and calling for help. These categories are consistent with the literature regarding hospital to home discharges for seniors and their caregivers. Family caregivers of hospitalized patients with dementia have additional needs beyond those of typical patients and collaboration with healthcare providers is vital to ensure patient needs are met. These findings highlight the importance of person-centered care delivery so that hospital discharge processes are tailored to the unique circumstances of each patient and caregiver.Nursin

Effects of ungulate herbivory on aspen, cottonwood, and willow development under forest fuels treatment regimes

Herbivory by domestic and wild ungulates can dramatically affect vegetation structure, composition and dynamics in nearly every terrestrial ecosystem of the world. These effects are of particular concern in forests of western North America, where intensive herbivory by native and domestic ungulates has the potential to substantially reduce or eliminate deciduous, highly palatable species of aspen (Populus tremuloides), cottonwood (Populus trichocarpa), and willow (Salix spp.). In turn, differential herbivory pressure may favor greater establishment of unpalatable conifers that serve as ladder fuels for stand-replacing fires. The resulting high fuel loads often require silvicultural fuels reductions to mitigate fire risk, which in turn may facilitate additional recruitment of deciduous species but also additional herbivory pressure. Potential interactions of ungulate herbivory with episodic disturbances of silviculture, fire, and other land uses are not well documented, but are thought to operate synergistically to affect forest dynamics. We evaluated individual and joint effects of ungulate herbivory and fuels reduction treatments in grand fir (Abies grandis) and Douglas-fir (Psuedotsuga menziezii) forests that dominate large areas of interior western North America. We applied fuels reduction treatments of mechanical thinning and prescribed fire and then evaluated the responses of aspen, cottonwood, and willow species to these treatments (N = 3) versus areas of no treatment (N = 3), and to exclusion from ungulate herbivory versus areas subjected to extant herbivory by free-ranging cattle (Bos taurus), elk (Cervus elaphus), and mule deer (Odocoileus hemionus). Densities of deciduous species were >4 times higher in response to fuels reduction treatments (84.4 individuals/ha) compared to areas of no treatment (19.7 individuals/ha). Additionally, when ungulates were excluded from fuels treated sites, the density of cottonwood was >5 times higher (122.5 individuals/ha) than fuels treated sites subjected to extant herbivory (24.3 individuals/ha). Similarly, densities of Populus spp. and Salix spp. were >3 times higher (211.6 individuals/ha) on fuels treated sites excluded from ungulate herbivory versus fuels treated sites subjected to extant herbivory (66.1 stems/ha). Deciduous species subjected to extant ungulate herbivory also were significantly lower in height, canopy surface area, and canopy volume than the same species inside the ungulate exclosures. Recruitment and long-term survival of aspen, cottonwood, and willow species in coniferous forests of interior western North America require a combination of episodic disturbances such as silviculture and fire to facilitate deciduous plant recruitment, followed by reductions in grazing pressure by domestic and wild ungulates during the time intervals between episodic disturbances to facilitate plant establishment, growth and survival.This is the publisher’s final pdf. The published article is copyrighted by Elsevier and can be found at: http://www.journals.elsevier.com/forest-ecology-and-management/Keywords: Chronic disturbances, Fire, Grazing, Ungulates, Fuels reduction, Forest dynamic

Conservation of the role of INNER NO OUTER in development of unitegmic ovules of the Solanaceae despite a divergence in protein function

The P-SlINO::SlINO-GFP transgene continues to be expressed after fertilization during the onset of fruit development. A-C: Ovules from P-SlINO::SlINO-GFP plants. D, E: Ovules from control plants. Images A (confocal) and B (DIC overlaid with GFP channel) show expression in the outer cell layer in an ovule post-anthesis. C-E are images of the surface cells of the integument of ovules taken from 3–4 mm fruits. C and D are images taken on an epifluorescence microscope (Axioplan) using a Chroma GFP filter set 41017 (Chroma, Bellows Falls, VT). E is a dark-field image of the same ovule in D. These images show expression is present in developing fruit. Scale bar in B represents 20 μm, scale bar in E represents 20 μm in C-E. (TIF 4435 kb

Reconstructing the basal angiosperm phylogeny: evaluating information content of mitochondrial genes

Three mitochondrial (atp1, matR, nad5), four chloroplast (atpB, matK, rbcL, rpoC2), and one nuclear (18S) genes from 162 seed plants, representing all major lineages of gymnosperms and angiosperms, were analyzed together in a supermatrix or in various partitions using likelihood and parsimony methods. The results show that Amborella + Nymphaeales together constitute the first diverging lineage of angiosperms, and that the topology of Amborella alone being sister to all other angiosperms likely represents a local long branch attraction artifact. The monophyly of magnoliids, as well as sister relationships between Magnoliales and Laurales, and between Canellales and Piperales, are all strongly supported. The sister relationship to eudicots of Ceratophyllum is not strongly supported by this study; instead a placement of the genus with Chloranthaceae receives moderate support in the mitochondrial gene analyses. Relationships among magnoliids, monocots, and eudicots remain unresolved. Direct comparisons of analytic results from several data partitions with or without RNA editing sites show that in multigene analyses, RNA editing has no effect on well supported relationships, but minor effect on weakly supported ones. Finally, comparisons of results from separate analyses of mitochondrial and chloroplast genes demonstrate that mitochondrial genes, with overall slower rates of substitution than chloroplast genes, are informative phylogenetic markers, and are particularly suitable for resolving deep relationships.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147147/1/tax25065680.pd

Long-Baseline Neutrino Facility (LBNF) and Deep Underground Neutrino Experiment (DUNE) Conceptual Design Report Volume 2: The Physics Program for DUNE at LBNF

The Physics Program for the Deep Underground Neutrino Experiment (DUNE) at the Fermilab Long-Baseline Neutrino Facility (LBNF) is described

Quantitative Live-Cell Imaging of Human Immunodeficiency Virus (HIV-1) Assembly

Advances in fluorescence methodologies make it possible to investigate biological systems in unprecedented detail. Over the last few years, quantitative live-cell imaging has increasingly been used to study the dynamic interactions of viruses with cells and is expected to become even more indispensable in the future. Here, we describe different fluorescence labeling strategies that have been used to label HIV-1 for live cell imaging and the fluorescence based methods used to visualize individual aspects of virus-cell interactions. This review presents an overview of experimental methods and recent experiments that have employed quantitative microscopy in order to elucidate the dynamics of late stages in the HIV-1 replication cycle. This includes cytosolic interactions of the main structural protein, Gag, with itself and the viral RNA genome, the recruitment of Gag and RNA to the plasma membrane, virion assembly at the membrane and the recruitment of cellular proteins involved in HIV-1 release to the nascent budding site

Thresholds of riparian forest use by terrestrial mammals in a fragmented Amazonian deforestation frontier

Species persistence in fragmented landscapes is intimately related to the quality, structure, and context of remaining habitat remnants. Riparian vegetation is legally protected within private landholdings in Brazil, so we quantitatively assessed occupancy patterns of terrestrial mammals in these remnants, examining under which circumstances different species effectively use them. We selected 38 riparian forest patches and five comparable riparian sites within continuous forest, at which we installed four to five camera-traps per site (199 camera-trap stations). Terrestrial mammal assemblages were sampled for 60 days per station during the dry seasons of 2013 and 2014. We modelled species occupancy and detection probabilities within riparian forest remnants, and examined the effects of patch size, habitat quality, and landscape structure on occupancy probabilities. We then scaled-up modelled occupancies to all 1915 riparian patches throughout the study region to identify which remnants retain the greatest potential to work as habitat for terrestrial vertebrates. Of the ten species for which occupancy was modelled, six responded to forest quality (remnant degradation, cattle intrusion, palm aggregations, and understorey density) or structure (remnant width, isolation, length, and area of the patch from which it originates). Patch suitability was lower considering habitat quality than landscape structure, and virtually all riparian remnants were unsuitable to maintain a high occupancy probability for all species that responded to forest patch quality or structure. Beyond safeguarding legal compliance concerning riparian remnant amount, ensuring terrestrial vertebrate persistence in fragmented landscapes will require curbing the drivers of forest degradation within private landholdings

The emergence of word-internal repetition through iterated learning:Explaining the mismatch between learning biases and language design

The idea that natural language is shaped by biases in learning plays a key role in our understanding of how human language is structured, but its corollary that there should be a correspondence between typological generalisations and ease of acquisition is not always supported. For example, natural languages tend to avoid close repetitions of consonants within a word, but developmental evidence suggests that, if anything, words containing sound repetitions are more, not less, likely to be acquired than those without. In this study, we use word-internal repetition as a test case to provide a cultural evolutionary explanation of when and how learning biases impact on language design. Two artificial language experiments showed that adult speakers possess a bias for both consonant and vowel repetitions when learning novel words, but the effects of this bias were observable in language transmission only when there was a relatively high learning pressure on the lexicon. Based on these results, we argue that whether the design of a language reflects biases in learning depends on the relative strength of pressures from learnability and communication efficiency exerted on the linguistic system during cultural transmission

Chemical Diversity and Defence Metabolism: How Plants Cope with Pathogens and Ozone Pollution

Chemical defences represent a main trait of the plant innate immune system. Besides regulating the relationship between plants and their ecosystems, phytochemicals are involved both in resistance against pathogens and in tolerance towards abiotic stresses, such as atmospheric pollution. Plant defence metabolites arise from the main secondary metabolic routes, the phenylpropanoid, the isoprenoid and the alkaloid pathways. In plants, antibiotic compounds can be both preformed (phytoanticipins) and inducible (phytoalexins), the former including saponins, cyanogenic glycosides and glucosinolates. Chronic exposure to tropospheric ozone (O3) stimulates the carbon fluxes from the primary to the secondary metabolic pathways to a great extent, inducing a shift of the available resources in favour of the synthesis of secondary products. In some cases, the plant defence responses against pathogens and environmental pollutants may overlap, leading to the unspecific synthesis of similar molecules, such as phenylpropanoids. Exposure to ozone can also modify the pattern of biogenic volatile organic compounds (BVOC), emitted from plant in response to herbivore feeding, thus altering the tritrophic interaction among plant, phytophagy and their natural enemies. Finally, the synthesis of ethylene and polyamines can be regulated by ozone at level of S-adenosylmethionine (SAM), the biosynthetic precursor of both classes of hormones, which can, therefore, mutually inhibit their own biosynthesis with consequence on plant phenotype