The Co-Occurrence of Polypharmacy and Unmet Needs for Social Care in Older People: A Systematic Review

\ua9 2024 Laurie E. Davies et al.Polypharmacy is common in older people who often live with disability and dependency. The number of older people living with unmet needs for social care is also believed to be rising. Polypharmacy is simple to operationalise, whilst unmet needs are not routinely identified but are known to adversely affect health and well-being. Therefore, this systematic review aimed to investigate whether polypharmacy is a marker of unmet needs for social care in older people. Sixteen databases were searched from inception to January 2021. Studies were included if they reported quantitative data for polypharmacy ("multiple medicines") in relation to unmet needs for social care ("relative or absolute") in older people ("study criteria aged ≥55 years or mean age ≥55 in the sample as a whole or stratified data for the ≥55-year age group") and were from a high-income country (defined by the World Bank). Quality was assessed using the National Institute for Health tool for observational studies. Four studies were identified from 2,549 citations, and overall, the quality of evidence was low. Some older people using multiple medications had their social care needs met, whilst others did not. However, there is a clear rationale as to why polypharmacy may be linked to unmet social care needs. Given the limited studies identified in this review, future research should explore this further. The type of unmet need measure may be important to understand the nature of the relationship between the use of multiple medications and unmet social care needs

Diesel Vehicle Research at BHP Collieries

Research into the control of diesel particulates (DP) has been conducted by BHP Coal for more than 7 years. Personal monitoring of employee exposures (n = 480 full shift samples) conducted at nine underground coal mines has indicated that the exposure of the workforce ranges from less than 0.1 to 2.2 mg/m3 of DP dependent on job type and mining operation. Approximately 50% of the mass of DP captured is elemental carbon (EC) which is the species currently being considered by some international regulatory authorities as the exposure standard. Five technologies for controlling DP were investigated in a combination of studies conducted in an above ground simulated tunnel, in a special controlled section of underground mine roadway and validated by application in standard coal mining operations at Tower Colliery . Tests conducted under controlled conditions indicate that dependent on the type of fuel in use, the introduction of low sulphur fuels can reduce DP levels in return airways by up to 50% and in actual mining situations a reduction of 20% can be achieved in exposure of the workforce. In addition, subjective responses from the workforce indicate that exhaust emissions from low sulphur fuels provide lower irritation and a more pleasant aroma. The use of water filled scrubber tanks reduces the level of DP emissions by 25%. Chemical decoking of engines resulted in a reduction of 20% in DP in return airways. A commercially available non-flammable disposable dry exhaust filter constructed from synthetic organic fibres with an operational lifetime in excess of 20 hours was found to reduce DP exhaust emissions by 80%. Investigations have indicated that the use of increased ventilation to control DP levels particularly in multiple vehicle situations does not follow a simple dilution factor and in some instances compliance with current regulatory requirements may not produce the required reduced exposure levels. The results from single component control strategies provide considerable reduction in exposure to DP, however the most efficient and cost effective control methodology is the use of a combination of individual systems modelled to operations conducted at each mine

Exclusive Breastfeeding Duration and Perceptions of Infant Sleep: The Mediating Role of Postpartum Anxiety

(1) Background: Existing literature has identified associations between exclusive breastfeeding, maternal mental health, and infant sleep. This study aims to examine these relationships simultaneously and consider the mediating role of postpartum anxiety. (2) Methods: Participants completed validated measures of postpartum anxiety, infant sleep, and reported exclusive breastfeeding duration. Postpartum mothers with infants between six and twelve months (n = 470) were recruited to a cross-sectional online survey containing a battery of psychological measures. (3) Results: Correlation analyses examined the relationships between the predictor (exclusive breastfeeding duration), outcome (perceptions of infant sleep), and mediator (postpartum anxiety). Exclusive breastfeeding duration was significantly associated with postpartum anxiety (p < 0.05), postpartum anxiety was significantly associated with perceptions of infant sleep (p < 0.001), and exclusive breastfeeding duration was significantly associated with perceptions of infant sleep (p < 0.001). A simple mediation model was conducted, showing a significant total (B = −0.029 (0.010), p < 0.05), direct (B = −0.035 (0.009), p < 0.001), and indirect effect (B = 0.007, SE = 0.003, 95% CI = 0.000 to 0.014) of exclusive breastfeeding duration on perceptions of infant sleep via postpartum anxiety. (4) Conclusions: Associations were identified between exclusive breastfeeding duration, postpartum anxiety, and perceptions of infant sleep. The mediation model suggests postpartum anxiety may be an underlying mechanism which reduces exclusive breastfeeding duration and negatively affects maternal perceptions of infant sleep quality

Reconstruction of microscopic thermal fields from oversampled infrared images in laser-based powder bed fusion

This article elucidates the need to consider the inherent spatial transfer function (blur), of any thermographic instrument used to measure thermal fields. Infrared thermographic data were acquired from a modified, commercial, laser-based powder bed fusion printer. A validated methodology was used to correct for spatial transfer function errors in the measured thermal fields. The methodology was found to make a difference of 40% to the measured signal levels and a 174 °C difference to the calculated effective temperature. The spatial gradients in the processed thermal fields were found to increase significantly. These corrections make a significant difference to the accuracy of validation data for process and microstructure modeling. We demonstrate the need for consideration of image blur when quantifying the thermal fields in laser-based powder bed fusion in this wor

‘Get yourself some nice, neat, matching box files’: research administrators and occupational identity work

To date, qualitative research into occupational groups and cultures within academia has been relatively scarce, with an almost exclusive concentration upon teaching staff within universities and colleges. This article seeks to address this lacuna and applies the interactionist concept of ‘identity work’ in order to examine one specific group to date under-researched: graduate research administrators. This occupational group is of sociological interest as many of its members appear to span the putative divide between ‘academic’ and ‘administrative’ occupational worlds within higher education. An exploratory, qualitative research project was undertaken, based upon interviews with 27 research administrators. The study analyses how research administrators utilise various forms of identity work to sustain credible occupational identities, often in the face of considerable challenge from their academic colleagues

A Spitzer/IRS Spectrum of the 2008 Luminous Transient in NGC 300: Connection to Proto-Planetary Nebulae

We present a Spitzer/IRS low-resolution mid-infrared spectrum (5-14 micron) of the luminous transient discovered in the nearby galaxy NGC 300 in May 2008. The spectrum, obtained three months after discovery, shows that the transient is very luminous in the mid-IR. Furthermore, the spectrum shows strong, broad emission features at 8 and 12 micron that are observed in Galactic carbon-rich proto-planetary nebulae. Combining these data with published optical and near-IR photometry obtained at the same epoch, we find that the mid-IR excess traced by the Spitzer spectrum accounts for ~20% of the total energy output. This component can be well explained by emission from ~3x10^-4 Msun of pre-existing progenitor dust at temperature ~400 K. The spectral energy distribution of the transient also shows a near-IR excess that can be explained by emission from newly-formed dust in the ejecta. Alternatively, both the near-IR and mid-IR excesses can together be explained by a single pre-existing geometrically thick dust shell. In light of the new observations obtained with Spitzer, we revisit the analysis of the optical spectra and kinematics, which were compared to the massive yellow-hypergiant IRC+10420 in previous studies. We show that proto-planetary nebulae share many properties with the NGC 300 transient and SN 2008S. We conclude that even though the explosion of a massive star (> 10 Msun) cannot be ruled out, an explosive event on a massive (6-10 Msun) carbon-rich AGB/super-AGB or post-AGB star is consistent with all observations of the transients and their progenitors presented thus far.Comment: 9 pages, 5 figures, 3 tables; references update

A census of atmospheric variability from seconds to decades

This paper synthesizes and summarizes atmospheric variability on time scales from seconds to decades through a phenomenological census. We focus mainly on unforced variability in the troposphere, stratosphere, and mesosphere. In addition to atmosphere-only modes, our scope also includes coupled modes, in which the atmosphere interacts with the other components of the Earth system, such as the ocean, hydrosphere, and cryosphere. The topics covered include turbulence on time scales of seconds and minutes, gravity waves on time scales of hours, weather systems on time scales of days, atmospheric blocking on time scales of weeks, the Madden–Julian Oscillation on time scales of months, the Quasi-Biennial Oscillation and El Niño–Southern Oscillation on time scales of years, and the North Atlantic, Arctic, Antarctic, Pacific Decadal, and Atlantic Multidecadal Oscillations on time scales of decades. The paper serves as an introduction to a special collection of Geophysical Research Letters on atmospheric variability. We hope that both this paper and the collection will serve as a useful resource for the atmospheric science community and will act as inspiration for setting future research directions

Specific DNA structural attributes modulate platinum anticancer drug site selection and cross-link generation

Heavy metal compounds have toxic and medicinal potential through capacity to form strong specific bonds with macromolecules, and the interaction of platinum drugs at the major groove nitrogen atom of guanine bases primarily underlies their therapeutic activity. By crystallographic analysis of transition metal–and in particular platinum compound–DNA site selectivity in the nucleosome core, we establish that steric accessibility, which is controlled by specific structural parameters of the double helix, modulates initial guanine–metal bond formation. Moreover, DNA conformational features can be linked to both similarities and distinctions in platinum drug adduct formation between the naked and nucleosomal DNA states. Notably, structures that facilitate initial platinum–guanine bond formation can oppose cross-link generation, rationalizing the occurrence of long-lived therapeutically ineffective monofunctional adducts. These findings illuminate DNA structure-dependent reactivity and provide a novel framework for understanding metal–double helix interactions, which should facilitate the development of improved chromatin-targeting medicinal agents

Classifying organisms and artefacts by their outline shapes

We often wish to classify objects by their shapes. Indeed, the study of shapes is an important part of many scientific fields, such as evolutionary biology, structural biology, image processing and archaeology. However, mathematical shape spaces are rather complicated and nonlinear. The most widely used methods of shape analysis, geometric morphometrics, treat the shapes as sets of points. Diffeomorphic methods consider the underlying curve rather than points, but have rarely been applied to real-world problems. Using a machine classifier, we tested the ability of several of these methods to describe and classify the shapes of a variety of organic and man-made objects. We find that one method, based on square-root velocity functions (SRVFs), outperforms all others, including a standard geometric morphometric method (eigenshapes), and that it is also superior to human experts using shape alone. When the SRVF approach is constrained to take account of homologous landmarks it can accurately classify objects of very different shapes. The SRVF method identifies a shortest path between shapes, and we show that this can be used to estimate the shapes of intermediate steps in evolutionary series. Diffeomorphic shape analysis methods, we conclude, now provide practical and effective solutions to many shape description and classification problems in the natural and human sciences.</p

TESS Discovery of an ultra-short-period planet around the nearby M dwarf LHS 3844

Data from the newly-commissioned \textit{Transiting Exoplanet Survey Satellite} (TESS) has revealed a "hot Earth" around LHS 3844, an M dwarf located 15 pc away. The planet has a radius of $1.32\pm 0.02$ $R_\oplus$ and orbits the star every 11 hours. Although the existence of an atmosphere around such a strongly irradiated planet is questionable, the star is bright enough ($I=11.9$, $K=9.1$) for this possibility to be investigated with transit and occultation spectroscopy. The star's brightness and the planet's short period will also facilitate the measurement of the planet's mass through Doppler spectroscopy.Comment: 10 pages, 4 figures. Submitted to ApJ Letters. This letter makes use of the TESS Alert data, which is currently in a beta test phase, using data from the pipelines at the TESS Science Office and at the TESS Science Processing Operations Cente