Bridging Aging and Domestic Violence Services in Our Communities

Educational Objectives 1. To describe the problem of domestic violence in later life. 2. To show how the operating principles and service approaches of aging (APS and aging network) and domestic violence service providers differ and may cause them to interpret the same situation differently. 3. To encourage aging and domestic violence service providers to share information, expertise, resources, and philosophical perspectives with one another in order to improve the community response to older battered women

Digitale 3D Analyse der Artefaktintensität von Keramik- und Titanimplantaten in digitaler Volumentomographie und Computertomographie

Hintergrund und Ziele: Für die orale Rehabilitation mittels implantatgetragenem Zahnersatz ist eine umfangreiche präoperative Behandlungsplanung für langfristige Therapieerfolge empfehlenswert. Virtuelle dreidimensionale (3D) Modelle, erstellt aus Digital Imaging And Communications In Medicine (DICOM)-Datensätzen, ermöglichen eine präzise Reproduktion individueller anatomischer Merkmale. Eine solche radiologische Bildgebung kann mittels Digitaler Volumentomographie (DVT) sowie Computertomographie (CT) realisiert werden. Allerdings kann die Aussagekraft der Volumendatensätze durch Artefakte, die von Strukturen wie dentalen Implantaten ausgehen können, eingeschränkt werden. Die resultierenden Artefakte können zu einer Maskierung relevanter anatomischer Strukturen und damit zu einer verschlechterten Bildqualität führen, wodurch die Beurteilbarkeit umliegender Hartgewebe sowohl im Schnittbild als auch im 3D Modell limitiert wird. Ziel dieser in-vitro Studie war es, die von dentalen Implantaten ausgehenden Artefakte in DVT und CT in Abhängigkeit des Implantatmaterials und des angewendeten Scanprotokolls quantitativ zu evaluieren. Methoden: Zu Beginn erfolgte unter standardisierten Bedingungen die Insertion von jeweils zuerst einem, und dann im folgenden Schritt zweier weiterer Keramik- (PURE Ceramic, Straumann, Basel, Schweiz) beziehungsweise Titanimplantate (Roxolid, Straumann, Basel, Schweiz) in die Mandibula an zwei humanen Kopfpräparaten. Zuvor (Pre OP) wie auch nach der Implantation von einem (OP 1) und von drei (OP 2) Implantaten wurden die Präparate im DVT sowie CT gescannt. Diese Datensätze wurden für folgende Einstellungen mit jeweils zehnfacher Wiederholung durchgeführt: 0,2 mm3 Voxel und 0,3 mm3 Voxel bei 120 kV im DVT (3D eXam, KaVo dental GmbH, Biberach, Deutschland) sowie 80 kV und 140 kV im CT (Somatom Definition AS, Siemens, Erlangen, Deutschland). Die generierten DICOM-Daten wurden anschließend zu 3D Modellen im STL-Format konvertiert und in eine industrielle CAD-Software für 3D Messtechnologie (GOM Inspect Professional, Version 2020, GOM GmbH, Braunschweig, Deutschland) importiert. Die 3D Pre OP Modelle (Soll-Wert) wurden hochpräzise mittels eines Softwarealgorithmus mit den postoperativen 3D Modellen (Ist-Wert) über die Knochenoberflächen übereinander gelagert und im Flächenvergleich analysiert. Dabei wurden die Oberflächenabweichungen der digitalen Modelle zur Artefaktbestimmung prozentual berechnet. Die deskriptive Statistik der Ergebnisse und die statistische Auswertung der zu vergleichenden Gruppen erfolgte mithilfe der Statistiksoftware „R“ (Version 3.6.3, R Core Team, Wien, Österreich). Ergebnisse und Beobachtungen: Das Ausmaß der Artefakte belief sich in der CT bei 140 kV und drei inserierten Titanimplantaten auf durchschnittlich 5,39 ± 0,45 % und dagegen für keramische Implantate im Schnitt auf 39,17 ± 0,53 %. Die Gegenüberstellung der beiden Materialien lieferte signifikante Unterschiede, wobei Keramikimplantate in der CT circa sieben mal mehr Artefakte erzeugten als Titanimplantate. Weiterhin war der Vergleich der Parametereinstellungen 80 kV und 140 kV in der CT signifikant und zeigte für die Artefakte bei drei Keramikimplantaten einen Wert von durchschnittlich 50,18 ± 1,21 % bei einer Einstellung von 80 kV, hingegen nur 39,17 ± 0,53 % bei 140 kV. Ähnliche Ergebnisse konnten auch bei Titanimplantaten mit 15,71 ± 1,28 % für 80 kV und 5,39 ± 0,45 % für 140 kV beobachtet werden. Den größten Anstieg der Artefaktintensität zwischen OP 1 und OP 2 lieferten die DVT-Modelle mit Keramikimplantaten mit einer Auflösung von 0,3 mm3 Voxel. Das Artefaktaufkommen stieg von 7,94 ± 0,41 % auf 36,53 ± 0,58 % an. Schlussfolgerungen und Diskussion: Die angewandte 3D Auswertungsmethode erlaubte eine quantitative Bestimmung vorhandener Artefakte in der CT- und DVT-Bildgebung. Mit den untersuchten Einstellungsparametern in CT und DVT konnte bei Keramik- im Vergleich zu Titanimplantaten ein höheres Ausmaß an Artefakten im 3D Modell beobachtet werden. Weiterhin konnten bei einer Röhrenspannung von 140 kV in der CT signifikant weniger Artefakte registriert werden als bei 80 kV

Physical Activity and Outdoor Play of Children in Public Playground : Do Gender and Social Environment Matter?

Background: Few studies have delved into the relationship of the social environment with children’s physical activity and outdoor play in public playgrounds by considering gender differences. The aim of the present study was to examine gender differences and the relationship of the social environment with children’s physical activity and outdoor play in public playgrounds. Methods: A quantitative, observational study was conducted at ten playgrounds in one district of a middle-sized town in Germany. The social environment, physical activity levels, and outdoor play were measured using a modified version of the System for Observing Play and Leisure Activity in Youth. Results: In total, 266 observations of children (117 girls/149 boys) between four and 12 years old were used in this analysis. Significant gender differences were found in relation to activity types, but not in moderate-to-vigorous physical activity (MVPA). The presence of active children was the main explanatory variable for MVPA. In the models stratified by gender, the presence of opposite-sex children was a significant negative predictor of MVPA in girls but not in boys. Conclusions: The presence of active children contributes to children’s physical activity levels in public playgrounds. Girls’ physical activity seems to be suppressed in the presence of boys

The economic cost of treatment-resistant depression in patients referred to a specialist service

Background: Patients with treatment-resistant depression (TRD) suffer very significant morbidity and are at a disadvantage concerning optimal clinical management. There are high associated societal costs. Aims: A detailed analysis of health economic costs in the United Kingdom in a group manifesting a severe form of TRD in the 12 months before their participation in a major randomized controlled treatment trial. Methods: The sample consisted of 118 participants from the Tavistock Adult Depression Study. Recruitment was from primary care on the basis of current major depression disorder of at least 2 years’ duration and two failed treatment attempts. Service utilization was assessed based on self-report and general practitioner (GP) medical records. Generalized linear models were used to identify predictors of cost. Results: All participants used GP services. Use of other doctors and practice nurses was also high. The mean total societal cost was £22 124, 80% of which was due to lost work and care required of families. Level of general functioning was found to be the most consistent predictor of costs. Conclusions: Severe forms of TRD are associated with high costs in which unpaid care and lost work predominate. Treatments that improve functioning may reduce the large degree of burden

Pharmacoproteomic characterisation of human colon and rectal cancer

Most molecular cancer therapies act on protein targets but data on the proteome status of patients and cellular models for proteome-guided pre-clinical drug sensitivity studies are only beginning to emerge. Here, we profiled the proteomes of 65 colorectal cancer (CRC) cell lines to a depth of > 10,000 proteins using mass spectrometry. Integration with proteomes of 90 CRC patients and matched transcriptomics data defined integrated CRC subtypes, highlighting cell lines representative of each tumour subtype. Modelling the responses of 52 CRC cell lines to 577 drugs as a function of proteome profiles enabled predicting drug sensitivity for cell lines and patients. Among many novel associations, MERTK was identified as a predictive marker for resistance towards MEK1/2 inhibitors and immunohistochemistry of 1,074 CRC tumours confirmed MERTK as a prognostic survival marker. We provide the proteomic and pharmacological data as a resource to the community to, for example, facilitate the design of innovative prospective clinical trials. © 2017 The Authors. Published under the terms of the CC BY 4.0 licens

Understanding the quality of life of family carers of people with dementia: development of a new conceptual framework

Background Dementia is a major global health and social care challenge, and family carers are a vital determinant of positive outcomes for people with dementia. This study's aim was to develop a conceptual framework for the Quality of Life (QOL) of family carers of people with dementia. Methods We studied family carers of people with dementia and staff working in dementia services iteratively using in‐depth individual qualitative interviews and focus groups discussions. Analysis used constant comparison techniques underpinned by a collaborative approach with a study‐specific advisory group of family carers. Results We completed 41 individual interviews with 32 family carers and nine staff and two focus groups with six family carers and five staff. From the analysis, we identified 12 themes that influenced carer QOL. These were organised into three categories focussing on person with dementia, carer, and external environment. Conclusions For carers of people with dementia, the QOL construct was found to include condition‐specific domains which are not routinely considered in generic assessment of QOL. This has implications for researchers, policy makers, and service providers in addressing and measuring QOL in family carers of people with dementia

Reference Genomes from Distantly Related Species Can Be Used for Discovery of Single Nucleotide Polymorphisms to Inform Conservation Management

Threatened species recovery programmes benefit from incorporating genomic data into conservation management strategies to enhance species recovery. However, a lack of readily available genomic resources, including conspecific reference genomes, often limits the inclusion of genomic data. Here, we investigate the utility of closely related high-quality reference genomes for single nucleotide polymorphism (SNP) discovery using the critically endangered kakī/black stilt (Himantopus novaezelandiae) and four Charadriiform reference genomes as proof of concept. We compare diversity estimates (i.e., nucleotide diversity, individual heterozygosity, and relatedness) based on kakī SNPs discovered from genotyping-by-sequencing and whole genome resequencing reads mapped to conordinal (killdeer, Charadrius vociferus), confamilial (pied avocet, Recurvirostra avosetta), congeneric (pied stilt, Himantopus himantopus) and conspecific reference genomes. Results indicate that diversity estimates calculated from SNPs discovered using closely related reference genomes correlate significantly with estimates calculated from SNPs discovered using a conspecific genome. Congeneric and confamilial references provide higher correlations and more similar measures of nucleotide diversity, individual heterozygosity, and relatedness. While conspecific genomes may be necessary to address other questions in conservation, SNP discovery using high-quality reference genomes of closely related species is a cost-effective approach for estimating diversity measures in threatened species

Measuring the quality of life of family carers of people with dementia: development and validation of C-DEMQOL

Purpose We aimed to address gaps identified in the evidence base and instruments available to measure the quality of life (QOL) of family carers of people with dementia, and develop a new brief, reliable, condition-specific instrument. Methods We generated measurable domains and indicators of carer QOL from systematic literature reviews and qualitative interviews with 32 family carers and 9 support staff, and two focus groups with 6 carers and 5 staff. Statements with five tailored response options, presenting variation on the QOL continuum, were piloted (n = 25), pre-tested (n = 122) and field-tested (n = 300) in individual interviews with family carers from North London and Sussex. The best 30 questions formed the C-DEMQOL questionnaire, which was evaluated for usability, face and construct validity, reliability and convergent/discriminant validity using a range of validation measures. Results C-DEMQOL was received positively by the carers. Factor analysis confirmed that C-DEMQOL sum scores are reliable in measuring overall QOL (ω = 0.97) and its five subdomains: ‘meeting personal needs’ (ω = 0.95); ‘carer wellbeing’ (ω = 0.91); ‘carer-patient relationship’ (ω = 0.82); ‘confidence in the future’ (ω = 0.90) and ‘feeling supported’ (ω = 0.85). The overall QOL and domain scores show the expected pattern of convergent and discriminant relationships with established measures of carer mental health, activities and dementia severity and symptoms. Conclusions The robust psychometric properties support the use of C-DEMQOL in evaluation of overall and domain-specific carer QOL; replications in independent samples and studies of responsiveness would be of value

An Improved Photometric Calibration of the Sloan Digital Sky Survey Imaging Data

We present an algorithm to photometrically calibrate wide field optical imaging surveys, that simultaneously solves for the calibration parameters and relative stellar fluxes using overlapping observations. The algorithm decouples the problem of "relative" calibrations, from that of "absolute" calibrations; the absolute calibration is reduced to determining a few numbers for the entire survey. We pay special attention to the spatial structure of the calibration errors, allowing one to isolate particular error modes in downstream analyses. Applying this to the Sloan Digital Sky Survey imaging data, we achieve ~1% relative calibration errors across 8500 sq.deg. in griz; the errors are ~2% for the u band. These errors are dominated by unmodelled atmospheric variations at Apache Point Observatory. These calibrations, dubbed "ubercalibration", are now public with SDSS Data Release 6, and will be a part of subsequent SDSS data releases.Comment: 16 pages, 17 figures, matches version accepted in ApJ. These calibrations are available at http://www.sdss.org/dr