Improving continence services for older people from the service-providers' perspective: a qualitative interview study

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.Objective To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting 3 acute and 13 primary care National Health Service Trusts in England. Participants 16 continence service leads in England actively treating and managing older people with UI. Results In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.Funding was received from the New Dynamics of Ageing Programme, led by the Economic & Social Research Council, UK (grantnumber RES-353-25-0010)

Surface velocity in the equatorial oceans (20N-20S) calculated from historical ship drifts

Ship drift velocity observations were used to calculate and plot monthly mean and yearly mean velocities in 2° latitude by 5° longitude boxes for the Atlantic, Pacific, and Indian Oceans. The vector maps shown here provide a visualization of the mean and seasonally varying currents.Funding was provided by the National Science Foundation through grant Number OCE 87-16509

Preliminary analysis of the fauna from Buffalo Cave, northern Transvaal, South Africa

Main articleSystematic excavations at Buffalo Cave in the Makapan Valley were begun in October 1993. This paper presents our preliminary analysis of the faunal assemblage from this site, including new in situ fossils and the collections which have been housed at the Bernard Price Institute, Palaeontology since the 1940's. Our palaeoecological reconstruction suggests that the local environment at Buffalo Cave at the time of deposition was an open country grassland or savanna, including a high proportion of alcelaphine bovids and other grazing fauna. However, the presence of other taxa, particularly of tragelaphines, hippotragines, and reduncines, may indicate that a more wooded habitat including a local water source, could also have been part of the Buffalo Cave environment during some part of its depositional history. The fauna overall indicates that deposition occurred during the Pleistocene, rather than the Pliocene. Thus, the environmental and temporal information presently available suggests that the Buffalo Cave fauna represents an environment and time period distinct from other sites in the Makapansgat Valley (i.e., the Limeworks and Cave of Hearths).FRD Core Programme grant and a University of the Witwatersrand Research Committee Gran

Task Dependence of Visual and Category Representations in Prefrontal and Inferior Temporal Cortices

Visual categorization is an essential perceptual and cognitive process for assigning behavioral significance to incoming stimuli. Categorization depends on sensory processing of stimulus features as well as flexible cognitive processing for classifying stimuli according to the current behavioral context. Neurophysiological studies suggest that the prefrontal cortex (PFC) and the inferior temporal cortex (ITC) are involved in visual shape categorization. However, their precise roles in the perceptual and cognitive aspects of the categorization process are unclear, as the two areas have not been directly compared during changing task contexts. To address this, we examined the impact of task relevance on categorization-related activity in PFC and ITC by recording from both areas as monkeys alternated between a shape categorization and passive viewing tasks. As monkeys viewed the same stimuli in both tasks, the impact of task relevance on encoding in each area could be compared. While both areas showed task-dependent modulations of neuronal activity, the patterns of results differed markedly. PFC, but not ITC, neurons showed a modest increase in firing rates when stimuli were task relevant. PFC also showed significantly stronger category selectivity during the task compared with passive viewing, while task-dependent modulations of category selectivity in ITC were weak and occurred with a long latency. Finally, both areas showed an enhancement of stimulus selectivity during the task compared with passive viewing. Together, this suggests that the ITC and PFC show differing degrees of task-dependent flexibility and are preferentially involved in the perceptual and cognitive aspects of the categorization process, respectively.National Institute of Mental Health (U.S.) (5R01MH065252-12)Alfred P. Sloan FoundationNatural Sciences and Engineering Research Council of Canada (Fellowship)McKnight Foundation (McKnight Scholar award

Radiation-Hydrodynamic Simulations of Collapse and Fragmentation in Massive Protostellar Cores

We simulate the early stages of the evolution of turbulent, virialized, high-mass protostellar cores, with primary attention to how cores fragment, and whether they form a small or large number of protostars. Our simulations use the Orion adaptive mesh refinement code to follow the collapse from ~0.1 pc scales to ~10 AU scales, for durations that cover the main fragmentation phase, using three-dimensional gravito-radiation hydrodynamics. We find that for a wide range of initial conditions radiation feedback from accreting protostars inhibits the formation of fragments, so that the vast majority of the collapsed mass accretes onto one or a few objects. Most of the fragmentation that does occur takes place in massive, self-shielding disks. These are driven to gravitational instability by rapid accretion, producing rapid mass and angular momentum transport that allows most of the gas to accrete onto the central star rather than forming fragments. In contrast, a control run using the same initial conditions but an isothermal equation of state produces much more fragmentation, both in and out of the disk. We conclude that massive cores with observed properties are not likely to fragment into many stars, so that, at least at high masses, the core mass function probably determines the stellar initial mass function. Our results also demonstrate that simulations of massive star forming regions that do not include radiative transfer, and instead rely on a barotropic equation of state or optically thin heating and cooling curves, are likely to produce misleading results.Comment: 23 pages, 18 figures, emulateapj format. Accepted to ApJ. This version has minor typo fixes and small additions, no significant changes. Resolution of images severely degraded to fit within size limit. Download the full paper from http://www.astro.princeton.edu/~krumholz/recent.htm

Measurement of electron screening in muonic lead

Energies of the transitions between high-lying (n≥6) states of muonic lead were accurately determined. The results are interpreted as a ∼2% test of the electron screening. The agreement between experiment and theory is good if it is assumed that the refilling of the electron K shell is fast. The present results furthermore severely restrict possible ionization of the electron L shell

Locked down apps versus the social media ecology : why do young people and educators disagree on the best delivery platform for digital sexual health entertainment education?

This article reports on focus groups exploring the best way to reach young men with vulgar comedy videos that provide sexual health information. Young people reported that they found the means by which the material was presented - as a locked down app - to be problematic, and that it would better be delivered through social media platforms such as YouTube. This would make it more 'spreadable'. By contrast, adult sex education stakeholders thought the material should be contained within a locked down, stand-alone app - otherwise it might be seen by children who are too young, and/or young people might misunderstand the messages. We argue that the difference in approach represented by these two sets of opinions represents a fundamental stumbling block for attempts to reach young people with digital sexual health materials, which can be understood through the prism of different cultural forms - education versus entertainment

Characterization of mesoscopic turbulent transport events with long-radial-range correlation in DIII-D H-mode plasmas

A dimensionless collisionality scan has been performed in H-mode plasmas on DIII-D tokamak, with detailed measurements of intermediate-to-high wavenumber turbulence using Doppler backscattering systems. It is found that the shorter wavelength turbulence develops into spatially asymmetric turbulent structures with a long-radial-range correlation (LRRC) in the mid-radius region of high-collisionality discharges. Linear \textsc{cgyro} simulations indicate that the underlying turbulence is likely driven by the electron-temperature-gradient (ETG) mode. The LRRC transport events are highly intermittent and show a power spectrum of $S_{\tilde{n}}(k_\perp) \propto k^{-1}_\perp$ for density fluctuations, which is often associated with self-organized criticality. The magnitude and the radial scale of those turbulent structures increase significantly when the $E_{r}\times B$ mean flow shearing rate decreases. The enhanced LRRC transport events appear to be correlated with the degraded energy confinement time. The emergence of such LRRC transport events may serve as a candidate explanation for the degrading nature of \emph{H}-mode core plasma confinement at high collisionality

Distribution and Kinematics of O VI in the Galactic Halo

FUSE spectra of 100 extragalactic objects are analyzed to obtain measures of O VI absorption along paths through the Milky Way thick disk/halo. Strong O VI absorption over the approximate velocity range from -100 to 100 km/s reveals a widespread but highly irregular distribution of thick disk O VI, implying the existence of substantial amounts of hot gas with T ~ 3x10^5 K in the Milky Way halo. Large irregularities in the distribution of the absorbing gas are found to be similar over angular scales extending from less than one to 180 degrees, indicating a considerable amount of small and large scale structure in the gas. The overall distribution of Galactic O VI is not well described by a symmetrical plane-parallel layer of patchy O VI absorption. The simplest departure from such a model that provides a reasonable fit to the observations is a plane-parallel patchy absorbing layer with a scale height of 2.3 kpc, and a 0.25 dex excess of O VI in the northern Galactic polar region. The O VI absorption has a Doppler parameter b = 30 to 99 km/s, with an average value of 60 km/s . Thermal broadening alone cannot explain the large observed profile widths. The average O VI absorption velocities toward high latitude objects range from -46 to 82 km/s, with a sample average of 0 km/s and a standard deviation of 21 km/s. O VI associated with the thick disk moves both toward and away from the plane with roughly equal frequency. A combination of models involving the radiative cooling of hot fountain gas, the cooling of supernova bubbles in the halo, and the turbulent mixing of warm and hot halo gases is required to explain the presence of O VI and other highly ionized atoms found in the halo. (abbreviated)Comment: 70 pages, single-spaced, PDF format. Bound copies of this manuscript and two accompanying articles are available upon request. Submitted to ApJ

CD4 memory T cells divide poorly in response to antigen because of their cytokine profile

Immunological memory is a hallmark of adaptive immunity, and understanding T cell memory will be central to the development of effective cell-mediated vaccines. The characteristics and functions of CD4 memory cells have not been well defined. Here we demonstrate that the increased size of the secondary response is solely a consequence of the increased antigen-specific precursor frequency within the memory pool. Memory cells proliferated less than primary responding cells, even within the same host. By analyzing the entry of primary and memory cells into the cell cycle, we found that the two populations proliferated similarly until day 5; after this time, fewer of the reactivated memory cells proliferated. At this time, fewer of the reactivated memory cells made IL-2 than primary responding cells, but more made IFNγ. Both these factors affected the low proliferation of the memory cells, because either exogenous IL-2 or inhibition of IFNγ increased the proliferation of the memory cells