Optimal management of urinary tract infections in older people

Urinary tract infections (UTI) occur frequently in older people. Unfortunately, UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary symptoms, with or without systemic symptoms. Urinalysis is commonly used to diagnose infection in this population, however, the evidence for its use is limited. There is overwhelming evidence that asymptomatic bacteriuria should not be treated. Catheter associated urinary tract infection accounts for a significant amount of hospital-associated infection. Indwelling urinary catheters should be avoided where possible and alternatives sought. The use of narrow spectrum antimicrobial agents for urinary tract infection is advocated. Local guidelines are now widely used to reflect local resistance patterns and available agents. Guidelines need to be updated to reflect changes in antimicrobial prescribing and a move from broad to narrow spectrum antimicrobials

Age Differences in Gaze Following : Older Adults Follow Gaze More than Younger Adults When free-viewing Scenes

Acknowledgements We thank Teodor Nikolov, Igne Umbrasaite, Bianca Bianciardi, Sarah Kenny, and Vestina Sciaponaite for assistance with stimuli selection and data collection. Funding details This research was supported by Grant RG14082 from the Economic and Social Research Council, awarded to Louise H. Phillips, Benjamin W. Tatler and Julie HenryPeer reviewedPostprin

The Halo and Rings of the Planetary Nebula NGC 40 in the Mid-Infrared

We present imaging and spectroscopy of NGC 40 acquired using the Spitzer Space Telescope (Spitzer), and the Infrared Space observatory (ISO). These are used to investigate the nature of emission from the central nebular shell, from the nebular halo, and from the associated circumnebular rings. It is pointed out that a variety of mechanisms may contribute to the mid-infrared (MIR) fluxes, and there is evidence for a cool dust continuum, strong ionic transitions, and appreciable emission by polycyclic aromatic hydrocarbons (PAHs). Prior observations at shorter wavelengths also indicate the presence of warmer grains, and the possible contribution of H2 transitions. It is suggested that an apparent jet-like structure to the NE of the halo represents one of the many emission spokes that permeate the shell. The spokes are likely to be caused by the percolation of UV photons through a clumpy interior shell, whilst the jet-like feature is enhanced due to locally elevated electron densities; a result of interaction between NGC 40 and the interstellar medium. It is finally noted that the presence of the PAH, 21 microns and 30 microns spectral features testifies to appreciable C/O ratios within the main nebular shell. Such a result is consistent with abundance determinations using collisionally excited lines, but not with those determined using optical recombination linesComment: 13 pages, 8 figures, Accepted for publication in MNRAS. 37 pages in arXi

Proximate drivers of spatial segregation in non-breeding albatrosses

Many animals partition resources to avoid competition, and in colonially-breeding species this often leads to divergent space or habitat use. During the non-breeding season, foraging constraints are relaxed, yet the patterns and drivers of segregation both between and within populations are poorly understood. We modelled habitat preference to examine how extrinsic (habitat availability and intra-specific competition) and intrinsic factors (population, sex and breeding outcome) influence the distributions of non-breeding grey-headed albatrosses Thalassarche chrysostoma tracked from two major populations, South Georgia (Atlantic Ocean) and the Prince Edward Islands (Indian Ocean). Spatial segregation was greater than expected, reflecting distinct seasonal differences in habitat selection and accessibility, and avoidance of intra-specific competition with local breeders. Previously failed birds segregated spatially from successful birds during summer, when they used less productive waters, suggesting a link between breeding outcome and subsequent habitat selection. In contrast, we found weak evidence of sexual segregation, which did not reflect a difference in habitat use. Our results indicate that the large-scale spatial structuring of albatross distributions results from interactions between extrinsic and intrinsic factors, with important implications for population dynamics. As habitat preferences differed substantially between colonies, populations should be considered independently when identifying critical areas for protectio

Teaching and learning in COVID-19 : Pandemic quilt storying

Something changed during the pandemic; we attuned to a call. A call to action, breathing, support, activism, care, well-being, community, minimised mobilities, planetary health and our relations to all these things, and more. We are women working in education spaces across multiple communities, responsive to ongoing matters of concern (Latour, 2008), aware that our rhizomic connections have no middle or end. We use the method and metaphor of the quilt in this collaboration and hold quilting as a Feminist intervention, a return to her-stories and ways of knowing through story as we stitch together cultural and material stories of place. Our COVID-19 chronicles are a creative, collaborative exploration of the initial impact of the COVID-19 pandemic on learning and teaching across our respective countries. This paper is a collaboration of critical auto-ethnographies (Holman Jones, 2016), quilted and stitched together by a group of education scholars who united to research the impact of online emergency teaching that forced education site closures globally. Through this collaborative image quilting, we curated responses to our initial 100-word stories of pandemic life in 2020, that we had posted on a collaborative Padlet. Feminist, storying, and ethnographic theory inform alignment and stitching of each 100-word patch

Perception of biological motion and emotion in mild cognitive impairment and dementia

Participants diagnosed with mild cognitive impairment (MCI), dementia and controls completed measures that required decoding emotions from point-light displays of bodily motion, and static images of facial affect. Both of these measures tap social cognitive processes that are considered critical for social competency. Consistent with prior literature, both clinical groups were impaired on the static measure of facial affect recognition. The dementia (but not the MCI) group additionally showed difficulties interpreting biological motion cues. However, this did not reflect a specific deficit in decoding emotions, but instead a more generalized difficulty in processing visual motion (both to action and to emotion). These results align with earlier studies showing that visual motion processing is disrupted in dementia, but additionally show for the first time that this extends to the recognition of socially relevant biological motion. The absence of any MCI related impairment on the point-light biological emotion measure (coupled with deficits on the measure of facial affect recognition) also point to a potential disconnect between the processes implicated in the perception of emotion cues from static versus dynamic stimuli. For clinical (but not control) participants, performance on all recognition measures was inversely correlated with level of semantic memory impairment

iPrevent®: a tailored, web-based, decision support tool for breast cancer risk assessment and management

We aimed to develop a user-centered, web-based, decision support tool for breast cancer risk assessment and personalized risk management. Using a novel model choice algorithm, iPrevent® selects one of two validated breast cancer risk estimation models (IBIS or BOADICEA), based on risk factor data entered by the user. Resulting risk estimates are presented in simple language and graphic formats for easy comprehension. iPrevent® then presents risk-adapted, evidence-based, guideline-endorsed management options. Development was an iterative process with regular feedback from multidisciplinary experts and consumers. To verify iPrevent®, risk factor data for 127 cases derived from the Australian Breast Cancer Family Study were entered into iPrevent®, IBIS (v7.02), and BOADICEA (v3.0). Consistency of the model chosen by iPrevent® (i.e., IBIS or BOADICEA) with the programmed iPrevent® model choice algorithm was assessed. Estimated breast cancer risks from iPrevent® were compared with those attained directly from the chosen risk assessment model (IBIS or BOADICEA). Risk management interventions displayed by iPrevent® were assessed for appropriateness. Risk estimation model choice was 100% consistent with the programmed iPrevent®logic. Discrepant 10-year and residual lifetime risk estimates of >1% were found for 1 and 4 cases, respectively, none was clinically significant (maximal variation 1.4%). Risk management interventions suggested by iPrevent® were 100% appropriate. iPrevent® successfully integrates the IBIS and BOADICEA risk assessment models into a decision support tool that provides evidence-based, risk-adapted risk management advice. This may help to facilitate precision breast cancer prevention discussions between women and their healthcare providers

Mental and perceptual feedback in the development of creative flow

Sketching is considered by artists and designers to be a vital tool in the creative process. However, research shows that externalisation during the creative process (i.e., sketching) is not necessary to create effectively. This study examines whether sketching may play a more important role in the subjective experience of creativity by facilitating the deeply focused, optimal state of consciousness termed ‘flow’ (being ‘in the zone’). The study additionally explored whether sketching affects flow by easing cognitive load or by providing a clearer sense of self-feedback. Participants carried out the creative mental synthesis task (combining sets of simple shapes into creative drawings), experimentally simulating the visual creative process. Ideas were generated either mentally before committing to a final drawing, or with external perceptual support through sketching, and cognitive load was varied by using either three- or five-shape sets. The sketching condition resulted in greater experience of flow and lower perceived task difficulty. However, cognitive load did not affect flow and there was no interaction between load and sketching conditions. These findings are the first to empirically demonstrate that sketching increases flow experience, and that this is not dependent on an associated reduction in overall working memory load

Using ecological and field survey data to establish a national list of the wild bee pollinators of crops

The importance of wild bees for crop pollination is well established, but less is known about which species contribute to service delivery to inform agricultural management, monitoring and conservation. Using sites in Great Britain as a case study, we use a novel qualitative approach combining ecological information and field survey data to establish a national list of crop pollinating bees for four economically important crops (apple, field bean, oilseed rape and strawberry). A traits data base was used to establish potential pollinators, and combined with field data to identify both dominant crop flower visiting bee species and other species that could be important crop pollinators, but which are not presently sampled in large numbers on crops flowers. Whilst we found evidence that a small number of common, generalist species make a disproportionate contribution to flower visits, many more species were identified as potential pollinators, including rare and specialist species. Furthermore, we found evidence of substantial variation in the bee communities of different crops. Establishing a national list of crop pollinators is important for practitioners and policy makers, allowing targeted management approaches for improved ecosystem services, conservation and species monitoring. Data can be used to make recommendations about how pollinator diversity could be promoted in agricultural landscapes. Our results suggest agri-environment schemes need to support a higher diversity of species than at present, notably of solitary bees. Management would also benefit from targeting specific species to enhance crop pollination services to particular crops. Whilst our study is focused upon Great Britain, our methodology can easily be applied to other countries, crops and groups of pollinating insects.LH was funded by NERC QMEE CDT. EJB was funded by a BBSRC Ph.D. studentship under grant BB/F016581/1. LB was was supported by the Scholarship Program of the German Federal Environmental Foundation (Deutsche Bundesstiftung Umwelt, DBU, AZ 20014/302). AJC was funded by the BBSRC and Syngenta UK as part of a case award Ph.D. (grant no. 1518739). AE was funded by the Swiss National Science Foundation (grant number 405940-115642). DG and A-MK were funded by grant PCIN2014-145-C02-02 (MinECo; EcoFruit project BiodivERsA-FACCE2014-74). MG was supported by Establishing a UK Pollinator Monitoring and Research Partnership (PMRP) a collaborative project funded by Defra, the Welsh and Scottish Governments, JNCC and project partners’. GAdG was funded via research projects BO-11-011.01-051 and BO-43-011.06-007, commissioned by the Dutch Ministry of Agriculture, Nature and Food Quality. DK was funded by the Dutch Ministry of Economic Affairs (BO-11-011.01-011). AK-H was funded by the NKFIH project (FK123813), the Bolyai János Fellowship of the MTA, the ÚNKP-19-4-SZIE-3 New National Excellence Program of the Ministry for Innovation and Technology, and together with RF by the Hungarian Scientific Research Fund OTKA 101940. MM was funded by Waitrose & Partners, Fruition PO, and the University of Worcester. MM was funded by grant INIA-RTA2013-00139-C03-01 (MinECo and FEDER). BBP and RFS were funded by the UK Natural Environment Research Council as part of Wessex BESS (ref. NE/J014680/1). NJV was funded by the Walloon Region (Belgium) Direction générale opérationnelle de l’Agriculture, des Ressources naturelles et de l’Environnement (DGO3) for the "Modèle permaculturel" project on biodiversity in micro-farms, FNRS/FWO joint programme EOS — Excellence Of Science CliPS: Climate change and its impact on Pollination Services (project 30947854)". CW was funded by the Deutsche Forschungsgemeinschaft (DFG) (Project number 405945293). BW was funded by the Natural Environment Research Council (NERC) under research programme NE/N018125/1 ASSIST – Achieving Sustainable Agricultural Systems www.assist.ceh.ac.uk. TB and TO are supported by BBSRC, NERC, ESRC and the Scottish Government under the Global Food Security Programme (Grant BB/R00580X/1)

Serum and follicular fluid organochlorine concentrations among women undergoing assisted reproduction technologies

<p>Abstract</p> <p>Background</p> <p>Exposure to persistent organic pollutants, including polychlorinated biphenyls (PCBs) and organochlorine pesticides, is widespread among the general population. There is evidence of adverse effects on reproduction and early pregnancy in relation to organochlorine exposure but human studies remain limited. The increased use of assisted reproductive technologies (ART) presents unique opportunities for the assessment of environmental influences on early pregnancy outcomes not otherwise observable in humans, but studies need to be designed to maximize the efficiency of the exposure data collected while minimizing exposure measurement error.</p> <p>Methods</p> <p>The present study was conducted to assess the correlation between concentrations of organochlorines in serum and follicular fluid samples collected from a subset of women undergoing ART in a large study that took place between 1994 and 2003, as well as the temporal reliability of serum organochlorine concentrations among women undergoing multiple ART cycles in the study. PCB congeners (118, 138, 153, and 180), 1,1,1-trichloro-2,2-bis(<it>p</it>-chlorophenyl)ethane (p,p'-DDT), the DDT metabolite p,p'-DDE, hexachlorobenzene (HCB), oxychlordane, trans-nonachlor and mirex were measured in 72 follicular fluid samples and 265 serum samples collected from 110 women.</p> <p>Results</p> <p>Organochlorine concentrations in paired serum and follicular fluid samples were correlated, with Pearson and Spearman coefficients ranging from 0.60 to 0.92. Serum organochlorine concentrations were two- to three-fold greater than in follicular fluid, and a significant inverse trend was observed in the distribution of follicular fluid:serum ratios with increasing molecular weight of the compound (p-value for trend < 0.0001). Serum organochlorine concentrations were highly reliable over the course of several months, with intraclass correlation coefficients ranging from 0.86 to 0.98. Finally, there was evidence for a declining trend in organochlorine concentrations between samples collected between years 1994–1998 and those collected in 1999–2003.</p> <p>Conclusion</p> <p>Our results support the use of a single serum sample to adequately represent a more biologically relevant dose (concentrations in follicular fluid), as well as exposure levels over time, in epidemiological studies of ART outcomes in relation to organochlorine exposure.</p