Older People with complex Health Needs Desire for Change: A Qualitative Study

As a sub study of another study we examined older people with complex health and disability support needs\u27 desire for change. The aim was to compare this across different ages, residence, and gender. Semi-structured interviews were held with 129 participants and the data were analyzed using a General Inductive Approach. Six themes emerged, Health, No Change, Personal Changes, Family, Housing, and Services. The two most popular themes were a desire for health changes and to have no change. Health professionals might note that older people in their 80s with significant health and disability impairments have a decrease in both the desire for health changes and any other changes

COMPARISON OF CONSEQUENCE ANALYSIS RESULTS FROM TWO METHODS OF PROCESSING SITE METEOROLOGICAL DATA

Consequence analysis to support documented safety analysis requires the use of one or more years of representative meteorological data for atmospheric transport and dispersion calculations. At minimum, the needed meteorological data for most atmospheric transport and dispersion models consist of hourly samples of wind speed and atmospheric stability class. Atmospheric stability is inferred from measured and/or observed meteorological data. Several methods exist to convert measured and observed meteorological data into atmospheric stability class data. In this paper, one year of meteorological data from a western Department of Energy (DOE) site is processed to determine atmospheric stability class using two methods. The method that is prescribed by the U.S. Nuclear Regulatory Commission (NRC) for supporting licensing of nuclear power plants makes use of measurements of vertical temperature difference to determine atmospheric stability. Another method that is preferred by the U.S. Environmental Protection Agency (EPA) relies upon measurements of incoming solar radiation, vertical temperature gradient, and wind speed. Consequences are calculated and compared using the two sets of processed meteorological data from these two methods as input data into the MELCOR Accident Consequence Code System 2 (MACCS2) code

PERSPECTIVES ON A DOE CONSEQUENCE INPUTS FOR ACCIDENT ANALYSIS APPLICATIONS

Department of Energy (DOE) accident analysis for establishing the required control sets for nuclear facility safety applies a series of simplifying, reasonably conservative assumptions regarding inputs and methodologies for quantifying dose consequences. Most of the analytical practices are conservative, have a technical basis, and are based on regulatory precedent. However, others are judgmental and based on older understanding of phenomenology. The latter type of practices can be found in modeling hypothetical releases into the atmosphere and the subsequent exposure. Often the judgments applied are not based on current technical understanding but on work that has been superseded. The objective of this paper is to review the technical basis for the major inputs and assumptions in the quantification of consequence estimates supporting DOE accident analysis, and to identify those that could be reassessed in light of current understanding of atmospheric dispersion and radiological exposure. Inputs and assumptions of interest include: Meteorological data basis; Breathing rate; and Inhalation dose conversion factor. A simple dose calculation is provided to show the relative difference achieved by improving the technical bases

Aging Impairs Recipient T Cell Intrinsic and Extrinsic Factors in Response to Transplantation

As increasing numbers of older people are listed for solid organ transplantation, there is an urgent need to better understand how aging modifies alloimmune responses. Here, we investigated whether aging impairs the ability of donor dendritic cells or recipient immunity to prime alloimmune responses to organ transplantation.Using murine experimental models, we found that aging impaired the host environment to expand and activate antigen specific CD8(+) T cells. Additionally, aging impaired the ability of polyclonal T cells to induce acute allograft rejection. However, the alloimmune priming capability of donor dendritic cells was preserved with aging.Aging impairs recipient responses, both T cell intrinsic and extrinsic, in response to organ transplantation

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

A Non-Lévy Random Walk in Chacma Baboons: What Does It Mean?

The Lévy walk is found from amoebas to humans and has been described as the optimal strategy for food research. Recent results, however, have generated controversy about this conclusion since animals also display alternatives to the Lévy walk such as the Brownian walk or mental maps and because movement patterns found in some species only seem to depend on food patches distribution. Here I show that movement patterns of chacma baboons do not follow a Lévy walk but a Brownian process. Moreover this Brownian walk is not the main process responsible for movement patterns of baboons. Findings about their speed and trajectories show that baboons use metal maps and memory to find resources. Thus the Brownian process found in this species appears to be more dependent on the environment or might be an alternative when known food patches are depleted and when animals have to find new resources

Moderate exercise may attenuate some aspects of immunosenescence

BACKGROUND: Immunosenescence is related to the deterioration of many immune functions, which may be manifested in increased susceptibility to infection, cancer, and autoimmunity. Lifestyle factors, such as diet or physical activity, may influence the senescence of the immune system. It is widely accepted that moderate physical activity may cause beneficial effects for physical and psychological health as well as for the immune system activity in aged people. METHODS: Thirty elderly women aged 62 to 86 were subjected to a two-years authorized physical activity program. Peripheral blood lymphocytes distribution and the production of cytokines involved in the immune response development and regulation (IL-2, IL-4 and IFN-γ) were investigated. The same parameters were evaluated in two control groups of women: a sedentary group of 12 elderly women selected for the second round of the physical activity program and in a group of 20 sedentary young women. Flow cytometry methods were used for the examination of surface markers on peripheral blood lymphocytes and intracellular cytokines expression. RESULTS: The distribution of the main lymphocytes subpopulations in the peripheral blood of elderly women did not show changes after long-term moderate physical training. The percentage of lymphocytes expressing intracellular IL-2 was higher in the group of women attending 2-years physical activity program than in the control group of elderly sedentary women, and it was similar to the value estimated in the group of young sedentary women. There was no difference in the intracellular expression of IL-4 and IFN-γ between the active and elderly sedentary women. CONCLUSIONS: Our results suggest that moderate, long-term physical activity in elderly women may increase the production of IL-2, an important regulator of the immune response. This may help ameliorate immunosenescence in these women

Recruitment and retention of women in a large randomized control trial to reduce repeat preterm births: the Philadelphia Collaborative Preterm Prevention Project

<p>Abstract</p> <p>Background</p> <p>Recruitment and retention of patients for randomized control trial (RCT) studies can provide formidable challenges, particularly with minority and underserved populations. Data are reported for the Philadelphia Collaborative Preterm Prevention Project (PCPPP), a large RCT targeting risk factors for repeat preterm births among women who previously delivered premature (< 35 weeks gestation) infants.</p> <p>Methods</p> <p>Design of the PCPPP incorporated strategies to maximize recruitment and retention. These included an advanced database system tracking follow-up status and assessment completion rates; cultural sensitivity training for staff; communication to the community and eligible women of the benefits of participation; financial incentives; assistance with transportation and supervised childcare services; and reminder calls for convenient, flexibly scheduled appointments. Analyses reported here: 1) compare recruitment projections to actual enrollment 2) explore recruitment bias; 3) validate the randomization process 4) document the extent to which contact was maintained and complete assessments achieved 5) determine if follow-up was conditioned upon socio-economic status, race/ethnicity, or other factors.</p> <p>Results</p> <p>Of eligible women approached, 1,126 (77.7%) agreed to participate fully. Of the 324 not agreeing, 118 (36.4%) completed a short survey. Consenting women were disproportionately from minority and low SES backgrounds: 71.5% consenting were African American, versus 38.8% not consenting. Consenting women were also more likely to report homelessness during their lifetime (14.6% vs. 0.87%) and to be unmarried at the time of delivery (81.6% versus 47.9%). First one-month postpartum assessment was completed for 83.5% (n = 472) of the intervention group (n = 565) and 76% (426) of the control group. Higher assessment completion rates were observed for the intervention group throughout the follow-up. Second, third, fourth and fifth postpartum assessments were 67.6% vs. 57.5%, 60.0% vs. 48.9%, 54.2% vs. 46.3% and 47.3% vs. 40.8%, for the intervention and control group women, respectively. There were no differences in follow-up rates according to race/ethnicity, SES or other factors. Greater retention of the intervention group may reflect the highly-valued nature of the medical and behavior services constituting the intervention arms of the Project.</p> <p>Conclusion</p> <p>Findings challenge beliefs that low income and minority women are averse to enrolling and continuing in clinical trials or community studies.</p