Accessibility and suitability of residential alcohol treatment for older adults: a mixed method study

Background Whilst alcohol misuse is decreasing amongst younger adults in many countries, it is increasing in older adults. Residential rehabilitation (rehab) is a vital component of the alcohol treatment system, particularly for those with relatively complex needs and entrenched alcohol problems. In this study, we sought to find out to what extent rehabs in England have upper age limits that exclude older adults, whether rehabs are responsive to older adults’ age-related needs and how older adults experience these services. Method This is a mixed method study. A search was carried out of Public Health England’s online directory of rehabs to identify upper age thresholds. Semi-structured qualitative interviews were carried out with 16 individuals who had attended one of five residential rehabs in England and Wales since their 50th birthday. A researcher with experience of a later life alcohol problem conducted the interviews. Results Of the 118 services listed on Public Health England’s online directory of rehabs, 75% stated that they had an upper age limit that would exclude older adults. Perceived differences in values, attitudes and behaviour between younger and older residents had an impact on older residents’ experience of rehab. Activities organised by the rehabs were often based on physical activity that some older adults found it difficult to take part in and this could create a sense of isolation. Some older adults felt unsafe in rehab and were bullied, intimidated and subjected to ageist language and attitudes. Conclusion This study identified direct and indirect age discrimination in rehabs contrary to the law. Further research is required to find out if age discrimination exists in rehabs in other countries. Rehabs should remove arbitrary age limits and ensure that they are responsive to the needs of older adults

Moyo Vol. VII N 1

Durica, Paul. Editor\u27s Letter . 4 Lemke, Angelica. Paxil, Effexor, and Prozac, Oh My! Is Depression Awareness Day Going Too Far? 5. Frey, Randall. Just Be: How to Make Money Without Really Doing Anything . 6. Purks, Robert. 007, Missing The Action. Dalton\u27s Bond Reconsidered . 7. Stine, Alison. Hatching A masterpiece: Jeffery Hatcher Talks of Writing, Melville, Woody Allen, and Denison . 8. Levine, Robert. Dial DU For Murder: Cinema Student Shuffles Off The Mortal Coil, and Finds it an Acquired Taste . 13. Almirall, Sarah. Dial DU For Murder: Cinema Student Shuffles Off The Mortal Coil, and Finds it an Acquired Taste, Photographs . 13. Werne, Kirsten. Back in the Day (Mom and Pop Alums Reflect on the Sixties Social Scene) . 18. Kohlbecker, Matthew. Between a Rock and a Hard Place (A Geological Excursion Into the Wilds of Canada) . 20. Lammont, Jean. Where\u27s Waldon? Comments on the Homestead . 21. Frey, Randall. Me Experimenting with Berry Beer . 25. Frey, Randall. Shoes for Mr. Jordan . 28. Porcheddu, Fred. My Late Adolescence . 30. Combe, Clayton. The Modern Guinea Pig . 31

Plasticity of an ultrafast interaction between nucleoporins and nuclear transport receptors.

The mechanisms by which intrinsically disordered proteins engage in rapid and highly selective binding is a subject of considerable interest and represents a central paradigm to nuclear pore complex (NPC) function, where nuclear transport receptors (NTRs) move through the NPC by binding disordered phenylalanine-glycine-rich nucleoporins (FG-Nups). Combining single-molecule fluorescence, molecular simulations, and nuclear magnetic resonance, we show that a rapidly fluctuating FG-Nup populates an ensemble of conformations that are prone to bind NTRs with near diffusion-limited on rates, as shown by stopped-flow kinetic measurements. This is achieved using multiple, minimalistic, low-affinity binding motifs that are in rapid exchange when engaging with the NTR, allowing the FG-Nup to maintain an unexpectedly high plasticity in its bound state. We propose that these exceptional physical characteristics enable a rapid and specific transport mechanism in the physiological context, a notion supported by single molecule in-cell assays on intact NPCs.We are grateful for helpful comments and various discussions with Cedric Debes, Martin Beck as well as the whole Lemke group. We thank Guillaume Bouvignies for help with relaxation dispersion experiments, and Damien Maurin for sample preparation. S.M. acknowledges funding from the Boehringer Ingelheim Fonds (BIF) and an EMBO long-term fellowship (ALTF 468-2014) and EC (EMBOCOFUND2012, GA-2012-600394) via Marie Curie Action. I.V.A. acknowledges a BIF short-term fellowship. J.C. and S.L.S. are supported by the Wellcome Trust. J.C. is a Wellcome Trust Senior Research Fellow (WT/095195). E.A.L. is grateful to funds from the SFB1129 and the Emmy Noether program of the DFG, F.G. from the Klaus Tschira Foundation, and D.M. from the BIOMS program of Heidelberg University. We are also grateful to instrument access via the EMBL Pepcore facility.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.cell.2015.09.04

The literacy practices for assessment in the vocational curriculum - the case of Hospitality

This article explores two case studies of the literacy practices of assessment in the vocational curriculum. Previous studies have identified learning in the vocational curriculum as being assessment-driven and that subjects often associated with limited levels of literacy actually require multiple literacy practices from students. Drawing upon studies of the literacy practices of assessment in the teaching of Hospitality, the study explores the academic and occupational forms of reading and writing required of students. These literacy practices are often invisible to both students and staff and yet are central to the success of students in relation to attainment. The article suggests that vocational subjects may actually be more demanding in the range of literacies required for assessment than is often considered to be the case

The Democratic Biopolitics of PrEP

PrEP (Pre-Exposure Prophylaxis) is a relatively new drug-based HIV prevention technique and an important means to lower the HIV risk of gay men who are especially vulnerable to HIV. From the perspective of biopolitics, PrEP inscribes itself in a larger trend of medicalization and the rise of pharmapower. This article reconstructs and evaluates contemporary literature on biopolitical theory as it applies to PrEP, by bringing it in a dialogue with a mapping of the political debate on PrEP. As PrEP changes sexual norms and subjectification, for example condom use and its meaning for gay subjectivity, it is highly contested. The article shows that the debate on PrEP can be best described with the concepts ‘sexual-somatic ethics’ and ‘democratic biopolitics’, which I develop based on the biopolitical approach of Nikolas Rose and Paul Rabinow. In contrast, interpretations of PrEP which are following governmentality studies or Italian Theory amount to either farfetched or trivial positions on PrEP, when seen in light of the political debate. Furthermore, the article is a contribution to the scholarship on gay subjectivity, highlighting how homophobia and homonormativity haunts gay sex even in liberal environments, and how PrEP can serve as an entry point for the destigmatization of gay sexuality and transformation of gay subjectivity. ‘Biopolitical democratization’ entails making explicit how medical technology and health care relates to sexual subjectification and ethics, to strengthen the voice of (potential) PrEP users in health politics, and to renegotiate the profit and power of Big Pharma

Widespread genomic influences on phenotype in Dravet syndrome, a 'monogenic' condition

Dravet syndrome is an archetypal rare severe epilepsy, considered "monogenic", typically caused by loss-of-function SCN1A variants. Despite a recognisable core phenotype, its marked phenotypic heterogeneity is incompletely explained by differences in the causal SCN1A variant or clinical factors. In 34 adults with SCN1A-related Dravet syndrome, we show additional genomic variation beyond SCN1A contributes to phenotype and its diversity, with an excess of rare variants in epilepsy-related genes as a set and examples of blended phenotypes, including one individual with an ultra-rare DEPDC5 variant and focal cortical dysplasia. Polygenic risk scores for intelligence are lower, and for longevity, higher, in Dravet syndrome than in epilepsy controls. The causal, major-effect, SCN1A variant may need to act against a broadly compromised genomic background to generate the full Dravet syndrome phenotype, whilst genomic resilience may help to ameliorate the risk of premature mortality in adult Dravet syndrome survivors

Galanin pathogenic mutations in temporal lobe epilepsy

Temporal lobe epilepsy (TLE) is a common epilepsy syndrome with a complex etiology. Despite evidence for the participation of genetic factors, the genetic basis of TLE remains largely unknown. A role for the galanin neuropeptide in the regulation of epileptic seizures has been established in animal models more than two decades ago. However, until now there was no report of pathogenic mutations in GAL, the galanin-encoding gene, and therefore its role in human epilepsy was not established. Here, we studied a family with a pair of monozygotic twins affected by TLE and two unaffected siblings born to healthy parents. Exome sequencing revealed that both twins carried a novel de novo mutation (p.A39E) in the GAL gene. Functional analysis revealed that the p.A39E mutant showed antagonistic activity against galanin receptor 1 (GalR1)-mediated response, and decreased binding affinity and reduced agonist properties for GalR2. These findings suggest that the p.A39E mutant could impair galanin signaling in the hippocampus, leading to increased glutamatergic excitation and ultimately to TLE. In a cohort of 582 cases, we did not observe any pathogenic mutations indicating that mutations in GAL are a rare cause of TLE. The identification of a novel de novo mutation in a biologically-relevant candidate gene, coupled with functional evidence that the mutant protein disrupts galanin signaling, strongly supports GAL as the causal gene for the TLE in this family. Given the availability of galanin agonists which inhibit seizures, our findings could potentially have direct implications for the development of anti-epileptic treatmen

Bypass or Engage? Explaining Donor Delivery Tactics

Abstract The conventional wisdom in the literature on aid allocation suggests that donors utilize bilateral aid as a tool to buy influence in the aid-receiving country. Those who conclude that aid is driven by donor self-interest focus on government-to-government aid transfers. However, this approach overlooks important variation in delivery tactics: bilateral donors frequently provide aid to non-state actors. This paper argues that donors resort to delivery tactics that increase the likelihood of aid achieving its intended outcome. In poorly governed recipient countries, donors bypass recipient governments and deliver more aid through non-state actors, all else equal. In recipient countries with higher governance quality, donors engage the government and give more aid through the government-to-government channel. Using OLS and Probit regressions, I find empirical support for this argument. Understanding the determinants of donor delivery tactics has important implications for assessing aid effectiveness

Mutations in GABRB3

Objective: To examine the role of mutations in GABRB3 encoding the b3 subunit of the GABAA receptor in individual patients with epilepsy with regard to causality, the spectrum of genetic variants, their pathophysiology, and associated phenotypes. Methods: We performed massive parallel sequencing of GABRB3 in 416 patients with a range of epileptic encephalopathies and childhood-onset epilepsies and recruited additional patients with epilepsy with GABRB3 mutations from other research and diagnostic programs. Results: We identified 22 patients with heterozygous mutations in GABRB3, including 3 probands frommultiplex families. The phenotypic spectrum of the mutation carriers ranged from simple febrile seizures, genetic epilepsies with febrile seizures plus, and epilepsy withmyoclonic-atonic seizures to West syndrome and other types of severe, early-onset epileptic encephalopathies. Electrophysiologic analysis of 7 mutations in Xenopus laevis oocytes, using coexpression of wild-type or mutant beta(3), together with alpha(5) and gamma(2s) subunits and an automated 2-microelectrode voltage-clamp system, revealed reduced GABA-induced current amplitudes or GABA sensitivity for 5 of 7 mutations. Conclusions: Our results indicate that GABRB3 mutations are associated with a broad phenotypic spectrum of epilepsies and that reduced receptor function causing GABAergic disinhibition represents the relevant disease mechanism

Rise in frequency of surface melting at Siple Dome through the Holocene : evidence for increasing marine influence on the climate of West Antarctica

Author Posting. © American Geophysical Union, 2008. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 113 (2008): D02112, doi:10.1029/2007JD008790.A new melt layer history from Siple Dome, West Antarctica, indicates notable late-Holocene summertime warming. Visual stratigraphic analyses of the 1004-m ice core identified 62 years with melt layers. Melting events began around 11.7 ka, followed by a period of no melting from 8.8–6.6 ka. Melt layer frequency increased from 6.6 ka to the present, with the 1000-year-average melt layer frequency reaching a maximum of 2% at 0.8 ka. We use our millennial-scale archive of melt events as a unique seasonal paleothermometer to elucidate changes in West Antarctic Holocene summer climate. Our calibration suggests the change in melt frequency from 0% to 2% may represent a summer temperature increase of ≥2°C from the middle to late Holocene. This temperature change cannot be explained entirely by local change in ice elevation or summer insolation and is in contrast to East Antarctic climate records, which show peak warmth in the early Holocene followed by stable or decreasing temperature. We interpret the rise in melt frequency as evidence of an increasing marine influence on the Ross Sea sector of West Antarctica. Although the surface elevation of Siple Dome has not changed greatly, the continued lateral retreat of the West Antarctic ice sheet from its Last Glacial Maximum configuration (across the outer continental shelf), and the delayed drawdown in ice thickness from the adjacent coastal Marie Byrd Land region, in conjunction with periods of increased cyclogenesis, perhaps related to variations in ENSO, would allow a moderated maritime climate to more easily reach West Antarctica.This research was supported by NSF grant OPP-9814485 and NASA grant NAG5-7776 to Penn State University and by a NASA Earth System Science Graduate Fellowship and a WHOI Postdoctoral Scholar Fellowship to S. Das. Additional support to R. Alley at PSU is from NSF grants 0440899, 0440447, and 0424589 and the Comer Science and Education Foundation