Improving health outcomes for the elderly an analytic framework

The authors present an analytic framework for investigating interactive gaming technologies and integrating a number of such technologies into a remote healthcare monioring system (ReMoteCare) to help improve the quality of life of the elderly, the chronically unwell and infirm whether they are living in their own homes or in aged care facilities. The framework covers population characteristics of the cohort, the interactive technologies as well as economic and environmental factors. It is anticipated that a series of interactive exercises, developed in conjunction with a Feldenkrais movement therapist who specializes in exercises for the elderly, will help to improve the physical and mental health outcomes of this cohort

Emergent resistance to dolutegravir among INSTI-naïve patients on first-line or second-line antiretroviral therapy : a review of published cases

None of the licensing studies of dolutegravir (DTG) reported any treatment-emergent resistance among DTG-treated individuals, though virological failure in treatment-naïve and treatment-experienced, integrase strand transfer inhibitor (INSTI)-naïve individuals has been reported in clinical practice. While the spectrum of dolutegravir-selected mutations and their effects on clinical outcome have been described, the clinical characteristics of these rare but important virological failure cases are often overlooked. In this perspective piece, we focus on key clinical aspects of emergent resistance to DTG among treatment-naïve and treatment-experienced INSTI-naïve patients, with an aim to inform clinical decision-making. Poor adherence and HIV disease factors contribute to emergent drug resistance, even in regimens with high resistance barriers. Patients with severe immunosuppression or poor adherence are under-represented in licensing studies, and these patients may be at higher risk of treatment failure with DTG resistance, which requires close clinical and laboratory follow-up.Publisher PDFPeer reviewe

Comparison of the Effects of Early Pregnancy with Human Interferon, Alpha 2 (IFNA2), on Gene Expression in Bovine Endometrium

Interferon tau (IFNT), a type I IFN similar to alpha IFNs (IFNA), is the pregnancy recognition signal produced by the ruminant conceptus. To elucidate specific effects of bovine IFNT and of other conceptus-derived factors, endometrial gene expression changes during early pregnancy were compared to gene expression changes after intrauterine application of human IFNA2. In experiment 1, endometrial tissue samples were obtained on Day (D) 12, D15, and D18 postmating from nonpregnant or pregnant heifers. In experiment 2, heifers were treated from D14 to D16 of the estrous cycle with an intrauterine device releasing IFNA2 or, as controls, placebo lipid extrudates or PBS only. Endometrial biopsies were performed after flushing the uterus. All samples from both experiments were analyzed with an Affymetrix Bovine Genome Array. Experiment 1 revealed differential gene expression between pregnant and nonpregnant endometria on D15 and D18. In experiment 2, IFNA2 treatment resulted in differential gene expression in the bovine endometrium. Comparison of the data sets from both studies identified genes that were differentially expressed in response to IFNA2 but not in response to pregnancy on D15 or D18. In addition, genes were found that were differentially expressed during pregnancy but not after IFNA2 treatment. In experiment 3, spatiotemporal alterations in expression of selected genes were determined in uteri from nonpregnant and early pregnant heifers using in situ hybridization. The overall findings of this study suggest differential effects of bovine IFNT compared to human IFNA2 and that some pregnancy-specific changes in the endometrium are elicited by conceptus-derived factors other than IFNT

Late onset of Huntington's disease

Twenty-five patients with late-onset Huntington's disease were studied; motor impairment appeared at age 50 years or later. The average age at onset of chorea was 57.5 years, with an average age at diagnosis of 63.1 years. Approximately 25% of persons affected by Huntington's disease exhibit late onset. A preponderance of maternal transmission was noted in late-onset Huntington's disease. The clinical features resembled those of mid-life onset Huntington's disease but progressed more slowly. Neuropathological evaluation of two cases reveal less severe neuronal atrophy than for mid-life onset disease

Validation of a 5-zone-car-cabin model to predict the energy saving potentials of a battery electric vehicle’s HVAC system

This paper presents a 5-zone-car-cabin model which is able to simulate the car cabin’s thermal condition depending on several influencing parameters. This includes the solar radiation, to which special attention is paid in this paper. In addition, a generic methodology for parameter optimization considering measurements on a reference vehicle is presented. Thus, a very high degree of determination of the model was achieved. This paper is motivated by the impact of auxiliary loads on overall energy consumption in battery electric vehicles. The further use of the model is intended to calculate the energy saving potentials of the heating, ventilation, and air conditioning system by reducing or increasing the target interior temperature. This is necessary for a predictive control of secondary consumers

A Few Signatories for the Proposal for an Association of Law Teachers

Letters from several professors who agreed to be signatories for the proposal for an association of law teachers

Educating healthcare workers to optimal hand hygiene practices: addressing the need

The education of healthcare workers is essential to improve practices and is an integral part of hand hygiene promotional strategies. According to the evidence reviewed here, healthcare worker education has a positive impact on improving hand hygiene and reducing healthcare-associated infection. Detailed practical guidance on steps for the organization of education programmes in healthcare facilities and teaching-learning strategies are provided using the World Health Organization (WHO) Guidelines for Hand Hygiene in Health Care as the basis for recommendations. Several key elements for a successful educational programme are also identified. A particular emphasis is placed on concepts included in the tools developed by WHO for education, monitoring and performance feedbac

Panel Discussion: Commenting on Theodore Lowi\u27s Law, Power, and Knowledge

Commenting on Theodore Lowi\u27s Law, Power, and Knowledge Participants: Professors Francis A. Allen, Theodore J. St. Antoine, Joseph L. Sax, and E. Philip Soper of the University of Michigan Low Schoo