Spirituality as a Life Line: Women Living With HIV/AIDS and the Role of Spirituality in Their Support System

For many women living with HIV/AIDS, incorporating spirituality into their lives helps them organize their experience, empower self-reconstruction, and manage stigma. (Stanley, 1999). Because of the potential relationship of spirituality and social support, the specific aim of this study is to examine the role of spirituality in the support experiences of women living with HIV or AIDS. In this case, spirituality or a connection to God, offered the women an opportunity to develop meaning and perspective taking, to have a source of support, to provide control through a more powerful being, and to offer a path to community

Food resources of stream macroinvertebrates determined by natural-abundance stable C and N isotopes and a 15N tracer addition

Trophic relationships were examined using natural-abundance 13C and 15N analyses and a 15N-tracer addition experiment in Walker Branch, a 1st-order forested stream in eastern Tennessee. In the 15N-tracer addition experiment, we added 15NH4, to stream water over a 6-wk period In early spring, and measured 15N:14N ratios in different taxa and biomass compartments over distance and time. Samples collected from a station upstream from the 15N addition provided data on natural-abundance 13C:12C and 15N:14N ratios. The natural-abundance 15N analysis proved to be of limited value in identifying food resources of macroinvertebrates because 15N values were not greatly different among food resources. In general, the natural-abundance stable isotope approach was most useful for determining whether epilithon or detritus were important food resources for organisms that may use both (e.g., the snail Elimia clavaeformis), and to provide corroborative evidence of food resources of taxa for which the 15N tracer results were not definitive. The 15N tracer results showed that the mayflies Stenonema spp. and Baetis spp. assimilated primarily epilithon, although Baetis appeared to assimilate a portion of the epilithon (e.g., algal cells) with more rapid N turnover than the bulk pool sampled. Although Elimia did not reach isotopic equilibrium during the tracer experiment, application of a N-turnover model to the field data suggested that it assimilated a combination of epilithon and detritus. The amphipod Gammarus minus appeared to depend mostly on fine benthic organic matter (FBOM), and the coleopteran Anchytarsus bicolor on epixylon. The caddisfly Diplectrona modesta appeared to assimilate primarily a fast N-turnover portion of the FBOM pool, and Simuliidae a fast N- turnover component of the suspended particulate organic matter pool rather than the bulk pool sampled. Together, the natural-abundance stable C and N isotope analyses and the experimental 15N tracer approach proved to be very useful tools for identifying food resources in this stream ecosystem

NITROGEN CYCLING IN A FOREST STREAM DETERMINED BY A 15N TRACER ADDITION

Nitrogen uptake and cycling was examined using a six‐week tracer addition of 15N‐labeled ammonium in early spring in Walker Branch, a first‐order deciduous forest stream in eastern Tennessee. Prior to the 15N addition, standing stocks of N were determined for the major biomass compartments. During and after the addition, 15N was measured in water and in dominant biomass compartments upstream and at several locations downstream. Residence time of ammonium in stream water (5–6 min) and ammonium uptake lengths (23–27 m) were short and relatively constant during the addition. Uptake rates of NH4 were more variable, ranging from 22 to 37 μg N·m−2·min−1 and varying directly with changes in streamwater ammonium concentration (2.7–6.7 μg/L). The highest rates of ammonium uptake per unit area were by the liverwort Porella pinnata, decomposing leaves, and fine benthic organic matter (FBOM), although epilithon had the highest N uptake per unit biomass N. Nitrification rates and nitrate uptake lengths and rates were determined by fitting a nitrification/nitrate uptake model to the longitudinal profiles of 15N‐NO3 flux. Nitrification was an important sink for ammonium in stream water, accounting for 19% of the total ammonium uptake rate. Nitrate production via coupled regeneration/nitrification of organic N was about one‐half as large as nitrification of streamwater ammonium. Nitrate uptake lengths were longer and more variable than those for ammonium, ranging from 101 m to infinity. Nitrate uptake rate varied from 0 to 29 μg·m−2·min−1 and was ∼1.6 times greater than assimilatory ammonium uptake rate early in the tracer addition. A sixfold decline in instream gross primary production rate resulting from a sharp decline in light level with leaf emergence had little effect on ammonium uptake rate but reduced nitrate uptake rate by nearly 70%. At the end of the addition, 64–79% of added 15N was accounted for, either in biomass within the 125‐m stream reach (33–48%) or as export of 15N‐NH4 (4%), 15N‐NO3 (23%), and fine particulate organic matter (4%) from the reach. Much of the 15N not accounted for was probably lost downstream as transport of particulate organic N during a storm midway through the experiment or as dissolved organic N produced within the reach. Turnover rates of a large portion of the 15N taken up by biomass compartments were high (0.04–0.08 per day), although a substantial portion of the 15N in Porella (34%), FBOM (21%), and decomposing wood (17%) at the end of the addition was retained 75 d later, indicating relatively long‐term retention of some N taken up from water. In total, our results showed that ammonium retention and nitrification rates were high in Walker Branch, and that the downstream loss of N was primarily as nitrate and was controlled largely by nitrification, assimilatory demand for N, and availability of ammonium to meet that demand. Our results are consistent with recent 15N tracer experiments in N‐deficient forest soils that showed high rates of nitrification and the importance of nitrate uptake in regulating losses of N. Together these studies demonstrate the importance of 15N tracer experiments for improving our understanding of the complex processes controlling N cycling and loss in ecosystems

Statin Discontinuation among Nursing Home Residents with Advanced Dementia

Background: Statin use in elderly individuals with life-limiting illness such as advanced dementia is controversial. Objective: To describe factors associated with statin discontinuation and estimate impact of discontinuation on 28-day hospitalizations in nursing home (NH) residents with advanced dementia. Methods: Retrospective cohort study of NH residents ≥ 65 years with recent progression to advanced dementia from 5 large U.S. states drawn from the 2007-2008 Minimum Data Set 2.0. We identified residents using statins. Clinical characteristics and 28-day hospitalization risk were compared for residents discontinuing and continuing statins. Multivariable Cox proportional hazard models identified factors associated with time to statin discontinuation and time to hospitalization. Sensitivity analysis using self-controlled case series examined the role of confounding-by-indication on risk estimation from the cohort approach. Results: Of 10,212 residents with decline to advanced dementia, 16.6% were prescribed statins (n=1,699). Statin users had mean age of 83.1 yrs, 68.9% were female, and mean medication burden was 10.3 (SD 4.8, range 1-31). Over one-third (n=632) discontinued in follow-up. Median time to discontinuation was 36 days after decline to advanced dementia (IQR [25%, 75%]: 12 days, 110 days). After adjustment, factors independently associated with increased hazard of discontinuation included residence in a NH in Florida relative to California, hospitalization in the 30 days prior to decline to advanced dementia, greater medication burden, and having cancer. The 28-day hospitalization risk was higher for residents discontinuing statins compared to continuing (adjusted hazard ratio = 1.78, CI 1.61,2.58). The SCCS estimate for 28-day hospitalization risk following statin discontinuation compared to a 28-day pre-discontinuation control period was lower than the cohort estimate (IRR= 0.79, CI 0.76, 0.83). Conclusion: A significant proportion of nursing home residents with dementia who use statins when they progress to advanced stage disease discontinue use. Hospitalization outcomes following discontinuation differ depending on method of estimation

Wildlife as Biosamplers: Contaminants in Hair of Elk Harvested Near the Anaconda Smelter Site

The purpose of this research was to test a new way of investigating biological uptake of smelting-related contaminants with a focus on harvested wildlife. Specific objectives were 1) to collect hair samples from elk (Cervus elaphus) harvested in the vicinity of the Anaconda Smelter National Priority List Site in Montana, 2) to analyze the samples using inductively coupled plasma – mass spectrometry (ICP-MS), and 3) to identify potential elements of concern from the data. Hair samples were collected from 56 elk, and concentration data were processed using a hazard quotient/index approach based on concepts commonly used in fields of ecological and human health risk analyses. Arsenic concentrations in the hair decreased as a function of increasing distance from the Anaconda smelter stack, and 57 % of the elk sampled were identified as animals of concern. For elk harvested within 25 km of the stack, elements of concern were aluminum, arsenic, barium, boron, lithium, manganese, molybdenum, strontium, and vanadium. For elk harvested within 76-101.5 km of the stack, elements of concern were aluminum, barium, boron, lithium, and manganese. Hazard indices for uranium, arsenic, cadmium, and lithium were larger by factors of ~17, 9, 7, and 6, respectively, for elk harvested within 25 km of the stack compared to hazard indices for elk harvested within 76-101.5 km

Statin use and adverse effects among adults \u3e 75 years of age: Insights from the Patient and Provider Assessment of Lipid Management (PALM) registry

Background: Current statin use and symptoms among older adults in routine community practice have not been well characterized since the release of the 2013 American College of Cardiology/American Heart Association guideline. Methods and results: We compared statin use and dosing between adults \u3e75 and ≤75 years old who were eligible for primary or secondary prevention statin use without considering guideline-recommended age criteria. The patients were treated at 138 US practices in the Patient and Provider Assessment of Lipid Management (PALM) registry in 2015. Patient surveys also evaluated reported symptoms while taking statins. Multivariable logistic regression models examined the association between older age and statin use and dosing. Among 6717 people enrolled, 1704 (25%) were \u3e75 years old. For primary prevention, use of any statin or high-dose statin did not vary by age group: any statin, 62.6% in those \u3e75 years old versus 63.1% in those ≤75 years old (P=0.83); high-dose statin, 10.2% versus 12.3% in the same groups (P=0.14). For secondary prevention, older patients were slightly less likely to receive any statin (80.1% versus 84.2% [P=0.003]; adjusted odds ratio, 0.81; 95% confidence interval, 0.66-1.01 [P=0.06]), but were much less likely to receive a high-intensity statin (23.5% versus 36.2% [PP=0.0001]). Among current statin users, older patients were slightly less likely to report any symptoms (41.3% versus 46.6%; P=0.003) or myalgias (27.3% versus 33.3%; Conclusions: Overall use of statins was similar for primary prevention in those aged \u3e75 years versus younger patients, yet older patients were less likely to receive high-intensity statins for secondary prevention. Statins appear to be similarly tolerated in older and younger adult

Quantitative Reasoning in Environmental Science: Rasch Measurement to Support QR Assessment

Original work is hosted at USF Libraries Scholar Commons publisher of Numeracy, the electronic journal of the National Numeracy Network (NNN). Abstract : The ability of middle and high school students to reason quantitatively within the context of environmental science was investigated. A quantitative reasoning (QR) learning progression, with associated QR assessments in the content areas of biodiversity, water, and carbon, was developed based on three QR progress variables: quantification act, quantitative interpretation, and quantitative modeling. Diagnostic instruments were developed specifically for the progress variable quantitative interpretation (QI), each consisting of 96 Likert-scale items. Each content version of the instrument focused on three scale levels (macro scale, micro scale, and landscape scale) and four elements of QI identified in prior research (trend, translation, prediction, and revision). The QI assessments were completed by 362, 6th to 12th grade students in three U.S. states. Rasch (1960/1980) measurement was used to determine item and person measures for the QI instruments, both to examine validity and reliability characteristics of the instrument administration and inform the evolution of the learning progression. Rasch methods allowed identification of several QI instrument revisions, including modification of specific items, reducing number of items to avoid cognitive fatigue, reconsidering proposed item difficulty levels, and reducing Likert scale to 4 levels. Rasch diagnostics also indicated favorable levels of instrument reliability and appropriate targeting of item abilities to student abilities for the majority of participants. A revised QI instrument is available for STEM researchers and educators