Understanding carers' fall concern and their management of fall risk among older people at home.

BACKGROUND: Many older people (care recipients) experience long-term psychological distress due to the fear of falling again. Falls can affect carers due to concerns about their care recipients falling. Understanding carers' fall concern is crucial to determine if carers are coping with the provision of care or have adequate knowledge and support in preventing their care recipients from falling at home. METHODS: A descriptive qualitative study was conducted to explore carers' concern about their care recipients being at risk of falling and their management of fall risk at home. Twenty-two carers were recruited from two research registers and a large tertiary hospital in a regional centre of Australia. Carers were interviewed face-to-face, or by telephone using a semi-structured interview guide about their fall concern. The data was analysed using an inductive content analysis method. RESULTS: Eight major themes emerged from the interviews. Four themes described key factors influencing carers' fall concern which include: 1) carers' perception of fall and fall risk, 2) care recipients' behaviour and attitude towards fall risk, 3) care recipients' health and function, and 4) care recipients' living environment. Another four themes described the management of care recipients' fall risk which include: 5) fall prevention strategies used, 6) risk of preventing falls, 7) support from family and friends, and 8) support from healthcare professionals. CONCLUSIONS: The findings from this qualitative study provide an insight into the carers' awareness of fall risk, knowledge, and the availability of support in preventing their care recipients from falling at home. Healthcare professionals are encouraged to include carers and address their fall concern to improve fall prevention programmes for care recipients at risk of falling at home

Carers' concerns about their older persons (Carees) at risk of falling - a mixed-methods study protocol.

BACKGROUND: When dependent older persons (carees) experience a fall at home, their carers worry that they will fall again. This ongoing concern affects the carers' wellbeing, perception of burden and can potentially change care arrangements. Previous research has focused on carers of high fall risk older persons with stroke, dementia or Parkinson's disease. However, little is known about the carers' concerns for carees at risk of falling generally; and there is no validated instrument to measure this concern. This study aims to explore carers' fall concern about carees at risk of falling and the development of an instrument to measure this concern. METHODS: This study utilises an exploratory sequential design in the development of an instrument to measure carers' concerns. Phase One will explore carers' fall concern using a descriptive qualitative approach. Phases Two and Three will involve expert review, pilot testing and field testing of the instrument. Twenty participants will be recruited by purposive sampling in phase one, and convenience sampling of 50 and 250 participants respectively, in Phases Two and Three. The participants will be recruited from research volunteer registers and local hospital outpatient clinics. Participants will be 18 years old and older and the main carer of an older person. Participants will be interviewed about their concerns about falls. Inductive content analysis will be used to analyse interviews and develop items for the instrument. The psychometric properties of the raw instrument will be tested using an online survey. This study has received ethics approval from the Hunter New England Human Health Research Ethics Committee. DISCUSSION: This study aims to provide greater depth of understanding about the psychological concerns and emotional burden related to carees' falls for carers. Quantifying carers' concerns will provide a context for interventions to assist and support carers and in the greater vigilance of monitoring the falling incidence of carees

A miniature bioassay for testing the acute phytotoxicity of photosystem II herbicides on seagrass

© 2015 Wilkinson et al. Photosystem II (PSII) herbicides have been detected in nearshore tropical waters such as those of the Great Barrier Reef and may add to the pressure posed by runoff containing sediments and nutrients to threatened seagrass habitats. There is a growing number of studies into the potential effects of herbicides on seagrass, generally using large experimental set-ups with potted plants. Here we describe the successful development of an acute 12-well plate phytotoxicity assay for the PSII herbicide Diuron using isolated Halophila ovalis leaves. Fluorescence images demonstrated Diuron affected the entire leaf surface evenly and responses were not influenced by isolating leaves from the plant. The optimum exposure duration was 24 h, by which time the inhibition of effective quantum yield of PSII (ΔF/Fm′) was highest and no deterioration of photosystems was evident in control leaves. The inhibition of ΔF/Fm′ by Diuron in isolated H. ovalis leaves was identical to both potted and hydroponically grown plants (with leaves remaining attached to rhizomes), indicating similar reductions in photosynthetic activity in these acute well-plate assays. The sensitivity of the assay was not influenced by irradiance (range tested 40 to 400 μmol photons m-2 s-1). High irradiance, however, caused photo-oxidative stress in H. ovalis and this generally impacted in an additive or sub-additive way with Diuron to damage PSII. The bioassay using isolated leaves is more rapid, uses far less biological material and does not rely on specialised aquarium facilities in comparison with assays using potted plants. The development and validation of this sensitive bioassay will be useful to reliably screen and monitor the phytotoxicity of existing and emerging PSII herbicides and contribute to risk assessments and water quality guideline development in the future

New Fathers' Perinatal Depression and Anxiety-Treatment Options: An Integrative Review.

More than 10% of fathers experience depression and anxiety during the perinatal period, but paternal perinatal depression (PPND) and anxiety have received less attention than maternal perinatal mental health problems. Few mainstream treatment options are available for men with PPND and anxiety. The aim of this literature review was to summarize the current understanding of PPND and the treatment programs specifically designed for fathers with perinatal depression. Eight electronic databases were searched using a predefined strategy, and reference lists were also hand searched. PPND and anxiety were identified to have a negative impact on family relationships, as well as the health of mothers and children. Evidence suggests a lack of support and tailored treatment options for men having trouble adjusting to the transition to fatherhood. Of the limited options available, cognitive behavioral therapy, group work, and blended delivery programs, including e-support approaches appear to be most effective in helping fathers with perinatal depression and anxiety. The review findings have important implications for the understanding of PPND and anxiety. Future research is needed to address the adoption of father-inclusive and father-specific models of care to encourage fathers' help-seeking behavior. Inclusion of male-specific requirements into support and treatment options can improve the ability of services to engage new fathers. Psychotherapeutic intervention could assist to address the cognitive differences and dissonance for men adjusting to the role of father, including male identity and role expectations

Plasma metabolites distinguish dementia with Lewy bodies from Alzheimer’s disease: a cross-sectional metabolomic analysis

Copyright \ua9 2024 Pan, Donaghy, Roberts, Chouliaras, O’Brien, Thomas, Heslegrave, Zetterberg, McGuinness, Passmore, Green and Kane.Background: In multifactorial diseases, alterations in the concentration of metabolites can identify novel pathological mechanisms at the intersection between genetic and environmental influences. This study aimed to profile the plasma metabolome of patients with dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD), two neurodegenerative disorders for which our understanding of the pathophysiology is incomplete. In the clinical setting, DLB is often mistaken for AD, highlighting a need for accurate diagnostic biomarkers. We therefore also aimed to determine the overlapping and differentiating metabolite patterns associated with each and establish whether identification of these patterns could be leveraged as biomarkers to support clinical diagnosis. Methods: A panel of 630 metabolites (Biocrates MxP Quant 500) and a further 232 metabolism indicators (biologically informative sums and ratios calculated from measured metabolites, each indicative for a specific pathway or synthesis; MetaboINDICATOR) were analyzed in plasma from patients with probable DLB (n = 15; age 77.6 \ub1 8.2 years), probable AD (n = 15; 76.1 \ub1 6.4 years), and age-matched cognitively healthy controls (HC; n = 15; 75.2 \ub1 6.9 years). Metabolites were quantified using a reversed-phase ultra-performance liquid chromatography column and triple-quadrupole mass spectrometer in multiple reaction monitoring (MRM) mode, or by using flow injection analysis in MRM mode. Data underwent multivariate (PCA analysis), univariate and receiving operator characteristic (ROC) analysis. Metabolite data were also correlated (Spearman r) with the collected clinical neuroimaging and protein biomarker data. Results: The PCA plot separated DLB, AD and HC groups (R2 = 0.518, Q2 = 0.348). Significant alterations in 17 detected metabolite parameters were identified (q ≤ 0.05), including neurotransmitters, amino acids and glycerophospholipids. Glutamine (Glu; q = 0.045) concentrations and indicators of sphingomyelin hydroxylation (q = 0.039) distinguished AD and DLB, and these significantly correlated with semi-quantitative measurement of cardiac sympathetic denervation. The most promising biomarker differentiating AD from DLB was Glu:lysophosphatidylcholine (lysoPC a 24:0) ratio (AUC = 0.92; 95%CI 0.809–0.996; sensitivity = 0.90; specificity = 0.90). Discussion: Several plasma metabolomic aberrations are shared by both DLB and AD, but a rise in plasma glutamine was specific to DLB. When measured against plasma lysoPC a C24:0, glutamine could differentiate DLB from AD, and the reproducibility of this biomarker should be investigated in larger cohorts

Universal access: the benefits and challenges in bringing integrated HIV care to isolated and conflict affected populations in the Republic of Congo

The Pool region of the Republic of Congo is an isolated, conflict-affected area with under-resourced and poorly functioning health care services. Despite significant AIDS-related mortality and morbidity in this area, and a national level commitment to universal HIV care, HIV has been largely neglected. In 2005 Médecins Sans Frontières decided to introduce HIV care activities. However, in this setting of high basic health care needs, limited medical resources and competing medical priorities, a vertical HIV programme was not suitable. This paper describes the process of integrating HIV care and treatment into basic health services, the clinical outcomes of 222 patients started on antiretroviral treatment (ART), and the benefits to communities and health care systems. Key lessons learned include the use of multi-skilled human resources, the step-wise implementation of HIV activities, the initial engagement of an HIV experienced staff member, the use of simplified and adapted testing, clinical and monitoring protocols and drug regimens, the introduction of more complex monitoring tools to simplify clinical management decisions and intensive staff education regarding the benefits of HIV integration. This project in a rural and remote conflict-affected setting demonstrates that integrated HIV programs can save lives and play a key role in helping to achieve universal access to ART in Africa

The 2021 outburst of the recurrent nova RS Ophiuchi observed in X-rays by the Neil Gehrels Swift Observatory: a comparative study

On 2021 August 8, the recurrent nova RS Ophiuchi erupted again, after an interval of 15.5 yr. Regular monitoring by the Neil Gehrels Swift Observatory began promptly, on August 9.9 (0.37 day after the optical peak), and continued until the source passed behind the Sun at the start of November, 86 days later. Observations then restarted on day 197, once RS Oph emerged from the Sun constraint. This makes RS Oph the first Galactic recurrent nova to have been monitored by Swift throughout two eruptions. Here we investigate the extensive X-ray datasets from 2006 and 2021, as well as the more limited data collected by EXOSAT in 1985. The hard X-rays arising from shock interactions between the nova ejecta and red giant wind are similar following the last two eruptions. In contrast, the early super-soft source (SSS) in 2021 was both less variable and significantly fainter than in 2006. However, 0.3–1 keV light-curves from 2021 reveal a 35 s quasi-periodic oscillation consistent in frequency with the 2006 data. The Swift X-ray spectra from 2021 are featureless, with the soft emission typically being well parametrized by a simple blackbody, while the 2006 spectra showed much stronger evidence for superimposed ionized absorption edges. Considering the data after day 60 following each eruption, during the supersoft phase the 2021 spectra are hotter, with smaller effective radii and lower wind absorption, leading to an apparently reduced bolometric luminosity. We explore possible explanations for the gross differences in observed SSS behaviour between the 2006 and 2021 outbursts

Pan-Chromatic observations of the Recurrent Nova LMC 2009a (LMC 1971b)

Nova LMC 2009a is confirmed as a Recurrent Nova (RN) from positional coincidence with nova LMC 1971b. The observational data set is one of the most comprehensive for any Galactic or extragalactic RN: optical and near-IR photometry from outburst until over 6 years later; optical spectra for the first 6 months, and Swift satellite Ultraviolet and X-ray observations from 9 days to almost 1 year post-outburst. We find $M_V = -8.4\pm0.8_{\mathrm{r}}\pm0.7_{\mathrm{s}}$ and expansion velocities between 1000 and 4000 km s$^{-1}$. Coronal line emission before day 9 indicates shocks in the ejecta. Strengthening of He II $\lambda$4686 preceded the emergence of the Super-Soft Source (SSS) in X-rays at $\sim63-70$ days, which was initially very variable. Periodic modulations, $P=1.2$ days, most probably orbital in nature, were evident in the UV and optical from day 43. Subsequently, the SSS shows an oscillation with the same period but with a delay of 0.28P. The progenitor system has been identified; the secondary is most likely a sub-giant feeding a luminous accretion disk. Properties of the SSS infer a white dwarf (WD) mass $1.1 \mathrm{M}_\odot \lesssim M_{\rm WD} \lesssim 1.3 \mathrm{M}_\odot$. If the accretion occurs at constant rate, $\dot{\it{M}}_{\rm acc} \simeq 3.6^{+4.7}_{-2.5} \times 10^{-7} \mathrm{M}_\odot$ yr$^{-1}$ is needed, consistent with nova models for an inter-eruption interval of 38 years, low outburst amplitude, progenitor position in the color-magnitude diagram, and spectral energy distribution at quiescence. We note striking similarities between LMC 2009a and the Galactic nova KT Eri, suggesting that KT Eri is a candidate RN

Photonic quantum technologies

The first quantum technology, which harnesses uniquely quantum mechanical effects for its core operation, has arrived in the form of commercially available quantum key distribution systems that achieve enhanced security by encoding information in photons such that information gained by an eavesdropper can be detected. Anticipated future quantum technologies include large-scale secure networks, enhanced measurement and lithography, and quantum information processors, promising exponentially greater computation power for particular tasks. Photonics is destined for a central role in such technologies owing to the need for high-speed transmission and the outstanding low-noise properties of photons. These technologies may use single photons or quantum states of bright laser beams, or both, and will undoubtably apply and drive state-of-the-art developments in photonics