Measuring unmet need for social care among older people

Recent spending cuts in the area of adult social care raise policy concerns about the proportion of older people whose need for social care is not met. Such concerns are emphasised in the context of population ageing and other demographic changes. This briefing summarises research published in Population Trends no. 145 which explores the concept of ‘unmet need’ for Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), using data on the receipt of support (informal, state or privately paid for). The results show that each of the three different support sectors tend to provide help for different kinds of need, and that worryingly, there is a significant level of ‘unmet need’ for certain activities

Spacecraft Charging Current Balance Model Applied to High Voltage Solar Array Operations

No abstract availabl

The role of non-suicidal self-injurious behavior on stress regulation in patients with current and remitted Borderline personality disorder

Borderline personality disorder (BPD) is characterized by disturbed affect regulation as well as disturbed emotion regulation, impulse control, interpersonal interaction and a profoundly disturbed self-image. Subjective levels of high aversive inner tension represent one of the main symptoms of this disease. 60-80% of all BPD patients show non-suicidal self-injurious behavior (NSSI). One of the major motives for NSSI is to cope with these states of high aversive inner tension. Interestingly, the majority of patients use tissue injuring methods. Previous studies have shown that in an experimental setting a small incision with a scalpel led to tension decrease in BPD patients. However, it is unclear what mechanisms underlie this phenomenon and whether the effect is rather due to tissue injury or pain perception or a combination of both. Furthermore, it is unclear to what extent states of aversive inner tension still exist in patients with remitted BPD and if pain perception still plays a role in stress regulation. In order to test the influence of tissue injury independently of pain perception, we investigated 57 female patients with current BPD and 60 healthy female controls. After 30 minutes of stress induction, either a small incision with a scalpel, a non-invasive nociceptive stimulus, in previous studies rated equally painful than the incision, or a non-invasive non-nociceptive tactile stimulus was applied to the right forearm. Throughout the study, subjective and objective stress parameters were recorded. As an immediate effect of stimulus application, we observed a greater decrease pf subjective tension ratings after the two painful stimuli compared to the control stimulus in current BPD patients. However, there was no difference in tension reduction between invasive and non-invasive pain stimulus among BPD patients. We performed the same examination in 30 female remitted BPD patients, to which 30 healthy controls and 30 current BPD patients were matched from the group described above. Here, the results showed that at the beginning of the measurement, the highest tension levels were found in current BPD patients, followed by remitted BPD patients, and the lowest tension ratings were found in healthy controls. During stress induction, patients with current BPD developed a stronger urge for NSSI than remitted BPD patients. In addition, the application of painful stimuli led to a greater decrease of subjective tension ratings in current compared to remitted BPD patients and healthy controls. No correlation between pain perception and stress regulation could be found in both remitted BPD patients and healthy controls. The results show that pain experience or nociceptive stimuli respectively, lead to a reduction of tension levels in patients with current BPD. However, we could not find any evidence for a larger decrease of tension levels due to tissue injury. With regard to remitted BPD patients, the results suggest a fading association between nociception and tension relief, as well as for a reduced presence of urge for NSSI, and for a normalization of pain evaluation

Automated, Ultra-Sterile Solid Sample Handling and Analysis on a Chip

There are no existing ultra-sterile lab-on-a-chip systems that can accept solid samples and perform complete chemical analyses without human intervention. The proposed solution is to demonstrate completely automated lab-on-a-chip manipulation of powdered solid samples, followed by on-chip liquid extraction and chemical analysis. This technology utilizes a newly invented glass micro-device for solid manipulation, which mates with existing lab-on-a-chip instrumentation. Devices are fabricated in a Class 10 cleanroom at the JPL MicroDevices Lab, and are plasma-cleaned before and after assembly. Solid samples enter the device through a drilled hole in the top. Existing micro-pumping technology is used to transfer milligrams of powdered sample into an extraction chamber where it is mixed with liquids to extract organic material. Subsequent chemical analysis is performed using portable microchip capillary electrophoresis systems (CE). These instruments have been used for ultra-highly sensitive (parts-per-trillion, pptr) analysis of organic compounds including amines, amino acids, aldehydes, ketones, carboxylic acids, and thiols. Fully autonomous amino acid analyses in liquids were demonstrated; however, to date there have been no reports of completely automated analysis of solid samples on chip. This approach utilizes an existing portable instrument that houses optics, high-voltage power supplies, and solenoids for fully autonomous microfluidic sample processing and CE analysis with laser-induced fluorescence (LIF) detection. Furthermore, the entire system can be sterilized and placed in a cleanroom environment for analyzing samples returned from extraterrestrial targets, if desired. This is an entirely new capability never demonstrated before. The ability to manipulate solid samples, coupled with lab-on-a-chip analysis technology, will enable ultraclean and ultrasensitive end-to-end analysis of samples that is orders of magnitude more sensitive than the ppb goal given in the Science Instruments

Measuring unmet need for social care amongst older people

Recent spending cuts in the area of adult social care raise policy concerns about the proportion of older people whose need for social care is not being met. Such concerns are emphasised in the context of population ageing and other demographic changes. For example, the increasing proportion of the population aged 75 and over places greater pressure on formal and informal systems of care and support provision, while changes in the living arrangements of older people may affect the supply of informal care within the household. This article explores the concept of "unmet need" for support in relation to specific Activities of Daily Living [ADLs] and Instrumental Activities of Daily Living [IADLs], using data on the receipt of support [informal, formal state or formal paid] from the General Household Survey, the English Longitudinal Study of Ageing and the British Household Panel Survey. The results show that different kinds of need tend to be supported by particular sources of care, and that there is a significant level of unmet need for certain activities

Resurrecting the interval of need concept to improve dialogue between researchers, policymakers, and social care practitioners

Academics, social care practitioners, and policymakers speak different languages. If academic research is to have an impact on society, it must be understandable and convincing to the end users. We argue that the conceptualisation of social care ‘need’ is different among these stakeholders, leading to poor communication between them. Academics should use concepts that have more meaning to practitioners. We propose resurrecting a little-used concept from the 1970s, ‘interval of need’, to help to bridge this gap. The interval of need concept identifies how often people require help, supplementing the usual data about types of tasks where assistance is needed. The history of the concept is described, followed by a test of its usefulness for today’s researchers by applying it to data from the English Longitudinal Study of Ageing. An updated version of interval of need is proposed. Validation checks were conducted against mortality data, and through conceptual validation from a social work practitioner. The nature of the dataset limited comparability with previous studies. However, we conclude that the interval of need concept has promising scope to enhance communication of research findings, potentially leading to improved outcomes for service users. This paper strives to mark a turning point in the language and analysis of social care, ensuring that academic investigation in this field is convincing and clear to practitioners and policymakers

The developing ovary of the South American plains vizcacha, Lagostomus maximus (Mammalia, Rodentia): Massive proliferation with no sign of apoptosis-mediated germ cell attrition

Apoptosis-dependent massive germ cell death is considered a constitutive trait of the developing mammalian ovary that eliminates 65-85% of the germinal tissue depending on the species. After birth and during adult lifetime, apoptotic activity moves from the germ cell proper to the somatic compartment, decimating germ cells through follicular atresia until the oocyte reserve is exhausted. In contrast, the South American rodent Lagostomus maximus shows suppressed apoptosis-dependent follicular atresia in the adult ovary, with continuous folliculogenesis and massive polyovulation, which finally exhausts the oocyte pool. The absence of follicular atresia in adult L. maximus might arise from a failure to move apoptosis from the germinal stratum to the somatic compartment after birth or being a constitutive trait of the ovarian tissue with no massive germ cell degeneration in the developing ovary. We tested these possibilities by analysing oogenesis, expression of germ cell-specific VASA protein, apoptotic proteins BCL2 and BAX, and DNA fragmentation by TUNEL assay in the developing ovary of L. maximus. Immunolabelling for VASA revealed a massive and widespread colonisation of the ovary and proliferation of germ cells organised in nests that disappeared at late development when folliculogenesis began. No sign of germ cell attrition was found at any time point. BCL2 remained positive throughout oogenesis, whereas BAXwas slightly detected in early development. TUNEL assay was conspicuously negative throughout the development. These results advocate for an unrestricted proliferation of germ cells, without apoptosis-driven elimination, as a constitutive trait of L. maximus ovary as opposed to what is normally found in the developing mammalian ovary.Fil: Leopardo, Noelia Paola. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Jensen, Cristian Federico. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Willis, Miguel Alfredo. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Espinosa, Maria Beatriz. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Vitullo, Alfredo Daniel. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Joint effect of physical activity and sedentary behaviour on cardiovascular risk factors in Chilean adults

Background: To investigate the associations between combined categories of moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) with markers of adiposity and cardiovascular risk in adults. Methods: Overall, 5040 participants (mean age 46.4 years and 59.3% women) from the cross-sectional Chilean National Health Survey 2009–2010 were included in this study. MVPA and SB were measured using the Global Physical Activity questionnaire. Four categories were computed using MVPA- and SB-specific cut-offs (‘High-SB & Active’, ‘Low-SB & Active’, ‘High-SB & Inactive’ and ‘Low-SB & Inactive’). Results: Compared to the reference group (‘High-SB & Inactive’), those in ‘High-SB & Active’ and ‘Low-SB & Active’ were less likely to have an obese BMI (OR: 0.67 [0.54; 0.85], P = 0.0001 and 0.74 [0.59; 0.92] P = 0.0007, respectively) and less likely to have metabolic syndrome (OR: 0.63 [0.49; 0.82], P < 0.0001 and 0.72 [0.57; 0.91], P = 0.007), central obesity (OR: 0.79 [0.65; 0.96], P = 0.016 and 0.71 [0.59; 0.84], P < 0.0001), diabetes (OR: 0.45 [0.35; 0.59], P < 0.0001 and 0.44 [0.34; 0.56], P < 0.0001) and hypertension (OR: 0.52 [0.43; 0.63], P < 0.0001 and 0.60 [0.50; 0.72], P < 0.0001), respectively. Conclusions: Being physically active and spending less time in SBs was associated with lower adiposity and improvements in cardiovascular risk factors

Injections of predatory bacteria work alongside host immune cells to treat Shigella infection in zebrafish larvae

Bdellovibrio bacteriovorus are predatory bacteria that invade and kill a range of Gram-negative bacterial pathogens in natural environments and in vitro [ 1 and 2]. In this study, we investigated Bdellovibrio as an injected, antibacterial treatment in vivo, using zebrafish (Danio rerio) larvae infected with an antibiotic-resistant strain of the human pathogen Shigella flexneri. When injected alone, Bdellovibrio can persist for more than 24 hr in vivo yet exert no pathogenic effects on zebrafish larvae. Bdellovibrio injection of zebrafish containing a lethal dose of Shigella promotes pathogen killing, leading to increased zebrafish survival. Live-cell imaging of infected zebrafish reveals that Shigella undergo rounding induced by the invasive predation from Bdellovibrio in vivo. Furthermore, Shigella-dependent replication of Bdellovibrio was captured inside the zebrafish larvae, indicating active predation in vivo. Bdellovibrio can be engulfed and ultimately eliminated by host neutrophils and macrophages, yet have a sufficient dwell time to prey on pathogens. Experiments in immune-compromised zebrafish reveal that maximal therapeutic benefits of Bdellovibrio result from the synergy of both bacterial predation and host immunity, but that in vivo predation contributes significantly to the survival outcome. Our results demonstrate that successful antibacterial therapy can be achieved via the host immune system working together with bacterial predation by Bdellovibrio. Such cooperation may be important to consider in the fight against antibiotic-resistant infections in vivo