Current and future directions in frailty research.

The concept of frailty has been evolving dramatically for the past 30 years. Through its evolution, a variety of single and multidimensional models have been used to describe frailty. This article reviews the current literature related to the defining dimensions of frailty and identifies the gaps in the literature requiring additional research. A detailed literature review was performed to identify key dimensions and models currently being used to define frailty, classify interventions that have been developed to reverse frailty, and identify potential areas for future research within this field. Despite the large body of research defining the dimensions of frailty, no consensus exists on a comprehensive, operational definition. A standardized definition will be critical to design effective interventions at earlier stages along the continuum of frailty and interpret findings from evaluation studies. Identified gaps in the literature include studies supporting the utility of expanding the definition of frailty to incorporate social determinants, studies evaluating the role of obesity in the development of frailty, and the need for longitudinal studies for defining the pathways to developing frailty. This review highlights the need for an accurate definition of frailty and for longitudinal research to explore the development of frailty and evaluate the effectiveness of the frailty reversal interventions that may avert or delay adverse outcomes within this susceptible population. These future research needs are discussed within the context of the growing pressures to bring down health care costs, and the role of comparative effectiveness research and cost-effectiveness research in identifying interventions with the potential to help slow the growth of health care spending among the elderly

Defund the Police: Moving Towards an Anti-Carceral Social Work

This paper addresses social work’s place in the movement to “defund the police.” We argue that social work’s collaboration with police and use of policing constitutes carceral social work. In defining carceral social work, we specify the ways in which coercive and punitive practices are used to manage Black, Indigenous, other people of color and poor communities across four social work arenas – gender-based violence, child welfare, schools, and health and mental health. To inform anti-carceral social work, we provide examples of interventions in these arenas that dismantle police collaborations and point to life-affirming, community-centered, and mutual aid alternatives

A professional development model to integrate computational thinking into middle school science through codesigned storylines

This article describes a professional development (PD) model, the CT-Integration Cycle, that supports teachers in learning to integrate computational thinking (CT) and computer science principles into their middle school science and STEM instruction. The PD model outlined here includes collaborative design (codesign; Voogt et al., 2015) of curricular units aligned with the Next Generation Science Standards (NGSS) that use programmable sensors. Specifically, teachers can develop or modify curricular materials to ensure a focus on coherent, student-driven instruction through the investigation of scientific phenomena that are relevant to students and integrate CT and sensor technology. Teachers can implement these storylines and collaboratively reflect on their instructional practices and student learning. Throughout this process, teachers may develop expertise in CT-integrated science instruction as they plan and use instructional practices aligned with the NGSS and foreground CT. This paper describes an examination of a group of five middle school teachers&rsquo; experiences during one iteration of the CT-Integration Cycle, including their learning, planning, implementation, and reflection on a unit they codesigned. Throughout their participation in the PD, the teachers expanded their capacity to engage deeply with CT practices and thoughtfully facilitated a CT-integrated unit with their students.</p

The ProPrems trial: investigating the effects of probiotics on late onset sepsis in very preterm infants

BACKGROUND: Late onset sepsis is a frequent complication of prematurity associated with increased mortality and morbidity. The commensal bacteria of the gastrointestinal tract play a key role in the development of healthy immune responses. Healthy term infants acquire these commensal organisms rapidly after birth. However, colonisation in preterm infants is adversely affected by delivery mode, antibiotic treatment and the intensive care environment. Altered microbiota composition may lead to increased colonisation with pathogenic bacteria, poor immune development and susceptibility to sepsis in the preterm infant.Probiotics are live microorganisms, which when administered in adequate amounts confer health benefits on the host. Amongst numerous bacteriocidal and nutritional roles, they may also favourably modulate host immune responses in local and remote tissues. Meta-analyses of probiotic supplementation in preterm infants report a reduction in mortality and necrotising enterocolitis. Studies with sepsis as an outcome have reported mixed results to date.Allergic diseases are increasing in incidence in "westernised" countries. There is evidence that probiotics may reduce the incidence of these diseases by altering the intestinal microbiota to influence immune function. METHODS/DESIGN: This is a multi-centre, randomised, double blinded, placebo controlled trial investigating supplementing preterm infants born at < 32 weeks' gestation weighing < 1500 g, with a probiotic combination (Bifidobacterium infantis, Streptococcus thermophilus and Bifidobacterium lactis). A total of 1,100 subjects are being recruited in Australia and New Zealand. Infants commence the allocated intervention from soon after the start of feeds until discharge home or term corrected age. The primary outcome is the incidence of at least one episode of definite (blood culture positive) late onset sepsis before 40 weeks corrected age or discharge home. Secondary outcomes include: Necrotising enterocolitis, mortality, antibiotic usage, time to establish full enteral feeds, duration of hospital stay, growth measurements at 6 and 12 months' corrected age and evidence of atopic conditions at 12 months' corrected age. DISCUSSION: Results from previous studies on the use of probiotics to prevent diseases in preterm infants are promising. However, a large clinical trial is required to address outstanding issues regarding safety and efficacy in this vulnerable population. This study will address these important issues. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN012607000144415The product "ABC Dophilus Probiotic Powder for Infants®", Solgar, USA has its 3 probiotics strains registered with the Deutsche Sammlung von Mikroorganismen und Zellkulturen (DSMZ--German Collection of Microorganisms and Cell Cultures) as BB-12 15954, B-02 96579, Th-4 15957

Risk factors for Coronavirus disease 2019 (Covid-19) death in a population cohort study from the Western Cape province, South Africa

Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates.Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1)

Multimodality SPECT imaging of multifocal spondylodiscitis

A 76-year-old woman with diabetes mellitus type 1 was admitted to our hospital with backache and high-grade fever for more than 6 weeks. Blood examination showed increased inflammatory parameters. Both SPECT Tc-99m MDP and Tc-99m ciprofloxacin scintigraphy demonstrated increased activity at the levels of D10-11 and L5-S1 vertebral discs, and a magnetic resonance image confirmed the diagnosis of spondylodiscitis at the corresponding levels without signs of medullary compression. Blood cultures were positive for Staphylococcus aureus. Intravenous broad-spectrum antibiotic therapy resulted in both a rapid clinical improvement and resolution of inflammatory parameters in the blood

Ethanol: Salvation or Damnation?

Contents: Opening Essay BY JOE STARITA Running on Empty: Food vs. Fuel BY MIMI ABEBE The recent boom in the ethanol industry has resulted in a greater demand for corn, which, in turn, has led to a strain on the supply, triggering higher prices Nightmares in the Ethanol Dream BY CASSIE FLEMING Politicians are quick to endorse the benefits of ethanol production. Others say that view is an illusion. Follow the Maize BY MIMI ABEBE The step-by-step stages of ethanol production History of Ethanol BY MIMI ABEBE Ethanol’s controversial history dates back to the 1800s Precise Portions BY CASSIE FLEMING Precision farming assists farmers in meeting government mandates for increased corn-ethanol production Subsidies Support Ethanol BY AARON E. PRICE The ethanol industry receives subsidies from every level of government Unlimited Resource or Looming Roadblock? BY AARON E. PRICE Conflicting needs for water complicate Nebraska’s effort to meet ethanol production goals Increased Corn Production Can Pollute Water BY AARON E. PRICE As farmers raise more corn for ethanol, they’re likely to use more nitrogen fertilizer and other chemicals that can pollute water Corn Monoculture No Friend of Biodiversity BY AARON E. PRICE Federal mandates for corn ethanol, which encourage farmers to plant more corn, may threaten the biodiversity of grasslands Honing in on the Homeland BY CASSIE FLEMING In 2006, the United States was the world’s top energy user Ethanol and the Elements BY MELISSA DROZDA and CAROLYN JOHNSEN Using ethanol in place of gasoline helps to reduce carbon dioxide emissions, but this solution may contribute to the problems New Deal or No Deal BY LUCAS JAMESON Minden’s city officials hope their ethanol plant will spark long-term economic growth Genesis on Hold BY LUCAS JAMESON The Genesis plant filed for bankruptcy, leaving millions of dollars owed to companies and local farmers Infrastructure Impacts BY CAROLYN JOHNSEN How will ethanol be moved around — from factory to distributor to vehicle? Sweet Ideas: Alternative Biofuels BY LUCAS JAMESON Scientists and farmers alike promote research of alternative energy crops but without necessary funds the search to find a cost-effective method continues Reporters, Photographers, Graphics, Documentary, Editors, Designers, Facult