The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups

Carers from BME and White British groups share many experiences of homecare although language and cultural difference may exacerbate common pressures and stresses. The framework for humanising care is a useful tool to evaluate aspects of homecare that are responsive to dignity and diversity. Implications for Rehabilitation Explicitly identifying, describing and valuing the human dimensions of care may support services in responding appropriately to homecare users from black minority ethnic communities as well as those from white majority groups. Unresponsive services and poor communication may lead to loss of trust with care agencies and undermine BME carers' sense of entitlement and competence in engaging with homecare services. Care worker continuity investing time in building relationships and care worker familiarity is important to many families who access social care services

Recommendations for and compliance with social restrictions during implementation of school closures in the early phase of the influenza A (H1N1) 2009 outbreak in Melbourne, Australia

Background Localized reactive school and classroom closures were implemented as part of a suite of pandemic containment measures during the initial response to influenza A (H1N1) 2009 in Melbourne, Australia. Infected individuals, and those who had been in close contact with a case, were asked to stay in voluntary home quarantine and refrain from contact with visitors for seven days from the date of symptom onset or exposure to an infected person. Oseltamivir (Tamiflu®) was available for treatment or prophylaxis. Methods We surveyed affected families through schools involved in the closures. Analyses of responses were descriptive. We characterized recommendations made to case and contact households and quantified adherence to guidelines and antiviral therapy. Results Of the 314 respondent households, 51 contained a confirmed case. The prescribed quarantine period ranged from 1-14 days, reflecting logistic difficulties in reactive implementation relative to the stated guidelines. Household-level compliance with the requirement to stay at home was high (84.5%, 95% CI 79.3,88.5) and contact with children outside the immediate family infrequent. Conclusions Levels of compliance with recommendations in our sample were high compared with other studies, likely due to heightened public awareness of a newly introduced virus of uncertain severity. The variability of reported recommendations highlighted the difficulties inherent in implementing a targeted reactive strategy, such as that employed in Melbourne, on a large scale during a public health emergency. This study emphasizes the need to understand how public health measures are implemented when seeking to evaluate their effectiveness

COPD prevalence in 12 Asia-Pacific countries and regions: Projections based on the COPD prevalence estimation model

Objective: COPD is a leading cause of mortality and morbidity worldwide. Despite the high rates of cigarette smoking, and the wide use of biomass fuels, there is very little objective data on the prevalence of COPD in Asia. Methodology: We used a COPD prevalence model to estimate the prevalence of COPD in 12 Asian countries. This model is a validated, computerized tool that uses epidemiological relationships and risk factor prevalence to project the prevalence of COPD within a given population aged 30 years and older. Results: The total number of moderate to severe COPD cases in the 12 countries of this region, as projected by the model, is 56.6 million with an overall prevalence rate of 6.3%. The COPD prevalence rates for the individual countries range from 3.5% (Hong Kong and Singapore) to 6.7% (Vietnam). Conclusions: The COPD prevalence rates projected by the model reflect the high prevalence of the risk factors for the disease in Asia. The combined prevalence of 6.3% for these countries is considerably higher than the overall rate of 3.8% as extrapolated from WHO data for this region. These estimates highlight the need for further epidemiological studies to support appropriate allocation of resources for the prevention and management of COPD.link_to_subscribed_fulltex

Nuclear structure of the odd-odd nucleus Co-58

The odd–odd 58 Co nucleus has been studied with the 51 V( 10 B, p2 n ) reaction at 33 MeV and 36 MeV incident energy using the γ -spectrometer Saci-Perer ˆ e. Excited states up to 8.0 MeV and spin up to 11 + have been observed. DSAM lifetimes for 13 excited states were measured. The results are compared to shell model calculations using the GXPF1 effective interaction, developed for use in the fp shell.status: publishe

Co-58: Structure of an odd-odd nucleus in the pf shell

High-spin states in the odd-odd 58 Co nucleus have been studied with the fusion-evaporation reaction 51 V( 10 B ,p 2 n ) using the γ -spectrometer Saci-Perere. Thirty-six new excited states up to spin 11 + and an excitation energy of 8.0 MeV have been observed, which are connected by 46 γ -ray transitions. Transition probabilities for 14 excited states were measured through the Doppler-shift attenuation method. The results are compared with shell-model calculations using the GXPF1 effective interaction, developed for use in the pf shell. These results were interpreted by considering particle-hole excitations with respect to the doubly magic N = Z = 28 core.status: publishe

Neurovascular unit on a chip: implications for translational applications

The blood–brain barrier (BBB) dynamically controls exchange between the brain and the body, but this interaction cannot be studied directly in the intact human brain or suffi ciently represented by animal models. Most existing in vitro BBB models do not include neurons and glia with other BBB elements and do not adequately predict drug effi cacy and toxicity. Under the National Institutes of Health Microtissue Initiative, we are developing a threedimensional, multicompartment, organotypic microphysiological system representative of a neurovascular unit of the brain. The neurovascular unit system will serve as a model to study interactions between the central nervous system neurons and the cerebral spinal fl uid (CSF) compartment, all coupled to a realistic blood-surrogate supply and venous return system that also incorporates circulating immune cells and the choroid plexus. Hence all three critical brain barriers will be recapitulated: blood–brain, brain–CSF, and blood–CSF. Primary and stem cell-derived human cells will interact with a variety of agents to produce critical chemical communications across the BBB and between brain regions. Cytomegalovirus, a common herpesvirus, will be used as an initial model of infections regulated by the BBB. This novel technological platform, which combines innovative microfl uidics, cell culture, analytical instruments, bioinformatics, control theory, neuroscience, and drug discovery, will replicate chemical communication, molecular traffi cking, and infl ammation in the brain. The platform will enable targeted and clinically relevant nutritional and pharmacologic interventions for or prevention of such chronic diseases as obesity and acute injury such as stroke, and will uncover potential adverse eff ects of drugs. If successful, this project will produce clinically useful technologies and reveal new insights into how the brain receives, modifi es, and is aff ected by drugs, other neurotropic agents, and diseases