Health Care in Rural Communities: Exploring the Development of Informal and Voluntary Care

Nation-state restructuring has resulted in significant political, economic and social change in rural communities. One manifestation of this transformation has been the changing nature of local governance, characterised by the re-working of central-local relations and public- private responsibilities, such that local informal and voluntary sectors now play an active and direct role in the organisation and delivery of health care services. This paper investigates the relationship between the changing nature of local governance and the provision of health care services, and places it within the context of rural communities and population aging in Canada. In particular, it considers the ascendancy of informal and voluntary sectors with respect to homecare in rural Ontario, and features an analysis of data from the National Population Health Survey and the National Survey of Giving, Volunteering and Participating, representing user (demand) and provider (supply) perspectives respectively. The results provide a cross-section of informal and voluntary home care in the late 1990s, which indicates that informal and voluntary sectors are major players in the local organisation and delivery of health care services in rural communities. This suggests that the current state of health care provision in rural communities of Ontario is affected very much by the changing nature of local governance associated with restructuring. The 'snap-shot' of health care in rural communities presented in this paper highlights the need to examine further the relationship between governance and health care services at the local level. It also points to the need for more detailed data sets that integrate health, informal and voluntary care data at meaningful geographical and administrative scales to reflect clearly rural communities in Canada.health care; rural communities

The role of telemedicine in the delivery of health care in the COVID‐19 pandemic

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162731/2/hae14044.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162731/1/hae14044_am.pd

A Spitzer Study of the Mass Loss Histories of Three Bipolar Pre-Planetary Nebulae

We present the results of far-infrared imaging of extended regions around three bipolar pre-planetary nebulae, AFGL 2688, OH 231.8+4.2, and IRAS 16342$-$3814, at 70 and 160 $\mu$m with the MIPS instrument on the Spitzer Space Telescope. After a careful subtraction of the point spread function of the central star from these images, we place constraints on the existence of extended shells and thus on the mass outflow rates as a function of radial distance from these stars. We find no apparent extended emission in AFGL 2688 and OH 231.8+4.2 beyond 100 arcseconds from the central source. In the case of AFGL 2688, this result is inconsistent with a previous report of two extended dust shells made on the basis of ISO observations. We derive an upper limit of $2.1\times10^{-7}$ M$_\odot$ yr$^{-1}$ and $1.0\times10^{-7}$ M$_\odot$ yr$^{-1}$ for the dust mass loss rate of AFGL 2688 and OH 231.8, respectively, at 200 arcseconds from each source. In contrast to these two sources, IRAS 16342$-$3814 does show extended emission at both wavelengths, which can be interpreted as a very large dust shell with a radius of $\sim$ 400 arcseconds and a thickness of $\sim$ 100 arcseconds, corresponding to 4 pc and 1 pc, respectively, at a distance of 2 kpc. However, this enhanced emission may also be galactic cirrus; better azimuthal coverage is necessary for confirmation of a shell. If the extended emission is a shell, it can be modeled as enhanced mass outflow at a dust mass outflow rate of $1.5\times10^{-6}$ M$_\odot$ yr$^{-1}$ superimposed on a steady outflow with a dust mass outflow rate of $1.5\times10^{-7}$ M$_\odot$ yr$^{-1}$. It is likely that this shell has swept up a substantial mass of interstellar gas during its expansion, so these estimates are upper limits to the stellar mass loss rate.Comment: 31 pages, 12 figures, accepted to A

Sensory attributes of wines made from vines of differing phosphorus status

Aim: The implications of water and nutrient deficiencies for photosynthesis, dry matter production, and yield have been well documented. However, whereas multiple studies show that water deficits affect grape and wine quality as well as wine sensory characteristics, the corresponding implications of manipulating vine nutrient status through fertilizer additions remain largely unexplored. Methods and results: In this study, phosphorus (P) fertilizers were applied to P-deficient vineyards of Cabernet Sauvignon, Chardonnay, and Chenin blanc growing in rhyolite, granite, and schist derived soils. Bloomtime leaf lamina P levels, basic soil chemical characteristics, juice P, and wine chemical parameters were measured after harvest. A highly sensitive protocol for sensory evaluation was used to test the wines made from the treated and untreated grapes for differences in wine appearance, flavor, aroma, and taste. All P additions were effective in rapidly increasing both vine P status and P in the harvested juice. In Cabernet Sauvignon vines growing on rhyolite, juice P was linearly related to vine P status compared to a non-linear accumulation of juice P in Chenin blanc vines growing on an calcium-rich schist soil. Soil CEC and Ca levels were both higher in the schist derived soil than in the rhyolite or granite soils, indicating a possible association of P release with soil parent material. Differences were detected in appearance, flavor, aroma, and taste in wines made from all three varieties on all three sites. Also, increasing vine P status increased the concentration of anthocyanins and soluble phenolics in the wines, and reduced fermentation time in the Cabernet Sauvignon. Conclusions: The results of this study show that vine P nutrient status can be manipulated by the grower across different soil types. Vine nutrient status has also been shown to significantly affect vine bud fertility, photosynthesis, dry matter and fruit production, and grape and wine chemical parameters. However, there is a lack of data describing the effect of manipulating vine nutrient status through fertilizer additions on the resulting wine sensory profile. Our results show that vine P status can influence the sensory attributes of wines. Significance and impact of the study: The results of this study and earlier work with vine water status identify two vineyard sources of variation in wine sensory attributes that occur both naturally and can be manipulated by the grower across different soil types

Instrumentation for Routine Analysis of Acrylamide in French Fries: Assessing Limitations for Adoption

The purpose of this experimental review was to detect acrylamide in French fries using methods most adaptable to the food process industry for quality control assessment of products. French fries were prepared at different cook times using the same fryer oil over a five-day period to assess the influence of oil degradation and monitor trends in acrylamide formation. Acrylamide detection was performed using LC-MS, GC-MS and FT-NIR. The low levels of acrylamide produced during frying, low molecular weight of the analyte, and complexity of the potato matrix make routine acrylamide measurement challenging in a well-outfitted analytical lab with trained personnel. The findings of this study are presented from the perspective of pros and cons of each acrylamide measurement method in enough detail for food processors to appraise the method that may work best for them based on their available instrumentation and extent of personnel training

Atmospheric wind measurements with the high-resolution Doppler imager

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/76745/1/AIAA-26590-119.pd

Aquilegia, Vol. 31 No. 6, Winter 2007, Newsletter of the Colorado Native Plant Society

https://epublications.regis.edu/aquilegia/1122/thumbnail.jp

World Federation of Hemophilia Gene Therapy Registry

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156126/2/hae14015_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156126/1/hae14015.pd

Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study.

BACKGROUND:Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. METHODS AND RESULTS:Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; P=0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [P=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [P=0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [P=0.002]) were significantly associated with lower cardiovascular event rates. CONCLUSIONS:Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data. CLINICAL TRIAL REGISTRATION:URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500