4,587 research outputs found
Intergenerational Ties in Context: Grandparents Caring for Grandchildren in China
Guided by theories and empirical research on intergenerational relationships, we examine the phenomenon of grandparents caring for grandchildren in contemporary China. Using a longitudinal dataset (China Health and Nutrition Survey), the authors document a high level of structural and functional solidarity in grandparent-grandchildren relationships. Intergenerational solidarity is indicated by a high rate of coresidence between grandchildren and grandparents, a sizable number of skipped-generation households (no parent present), extensive childcare involvement by non-coresidential grandparents, and a large amount of care provided by coresidential grandparents. Multivariate analysis further suggests that grandparents’ childcare load is adaptive to familial needs, as reflected by the characteristics of the household, household members and work activities of the mothers
Events and sustainability: why making events more sustainable is not enough
The special issue dedicated to events and sustainability is introduced here. We provide synopses of the papers, preceded by an introductory essay that examines how event studies has approached the relationship between events and sustainable development. Existing work too often assumes that sustainability means reducing negative environmental impacts with other aspects of the sustainability paradigm neglected. And whilst social issues have risen to prominence in events research generally, this work is usually considered outwith sustainability debates, and without considering environmental and economic interrelationships. We argue that event scholars should examine how events might contribute to sustainable development, rather than merely exploring how individual events could be made more sustainable. Accordingly, there needs to be further work addressing how events might change attitudes and behaviours by promoting sustainable lifestyles, communities and technologies. Following this discussion, we justify the focus on social sustainability in the special issue, clarify what this actually means, and question whether this is always the most appropriate way of framing research on the social impacts of events. Given the timing of the special issue, there is also a short review of how the coronavirus crisis affected the events sector, and what the implications might be for sustainability
Vagal nerve stimulation therapy: what is being stimulated?
Vagal nerve stimulation in cardiac therapy involves delivering electrical current to the vagal sympathetic complex in patients experiencing heart failure. The therapy has shown promise but the mechanisms by which any benefit accrues is not understood. In this paper we model the response to increased levels of stimulation of individual components of the vagal sympathetic complex as a differential activation of each component in the control of heart rate. The model provides insight beyond what is available in the animal experiment in as much as allowing the simultaneous assessment of neuronal activity throughout the cardiac neural axis. The results indicate that there is sensitivity of the neural network to low level subthreshold stimulation. This leads us to propose that the chronic effects of vagal nerve stimulation therapy lie within the indirect pathways that target intrinsic cardiac local circuit neurons because they have the capacity for plasticity
Seasonal variations in Greenland Ice Sheet motion : Inland extent and behaviour at higher elevations
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Author accepted manuscript: Memory for staged events: supporting older and younger adults' memory with SenseCam
Two experiments measured the effect of retrieval support provided by a wearable camera, SenseCam, on older and younger adults’ memory for a recently experienced complex staged event. In each experiment participants completed a series of tasks in groups and the events were recalled two weeks later, after viewing SenseCam images (experimental condition) or thinking about the event (control condition). When IQ and education were matched, young adults recalled more event details than older adults, demonstrating an agerelated deficit for novel autobiographical material. Reviewing SenseCam images increased the number of details recalled by older and younger adults, and the effect was similar for both groups. These results suggest that memory can be supported by the use of SenseCam, but the age-related deficit is not eliminated
Pharmacist intervention in primary care to improve outcomes in patients with left ventricular systolic dysfunction
<b>Background</b> Meta-analysis of small trials suggests that pharmacist-led collaborative review and revision of medical treatment may improve outcomes in heart failure.<p></p>
<b>Methods and results</b> We studied patients with left ventricular systolic dysfunction in a cluster-randomized controlled, event driven, trial in primary care. We allocated 87 practices (1090 patients) to pharmacist intervention and 87 practices (1074 patients) to usual care. The intervention was delivered by non-specialist pharmacists working with family doctors to optimize medical treatment. The primary outcome was a composite of death or hospital admission for worsening heart failure. This trial is registered, number ISRCTN70118765. The median follow-up was 4.7 years. At baseline, 86% of patients in both groups were treated with an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. In patients not receiving one or other of these medications, or receiving less than the recommended dose, treatment was started, or the dose increased, in 33.1% of patients in the intervention group and in 18.5% of the usual care group [odds ratio (OR) 2.26, 95% CI 1.64–3.10; P< 0.001]. At baseline, 62% of each group were treated with a β-blocker and the proportions starting or having an increase in the dose were 17.9% in the intervention group and 11.1% in the usual care group (OR 1.76, 95% CI 1.31–2.35; P< 0.001). The primary outcome occurred in 35.8% of patients in the intervention group and 35.4% in the usual care group (hazard ratio 0.97, 95% CI 0.83–1.14; P = 0.72). There was no difference in any secondary outcome.<p></p>
<b>Conclusion</b> A low-intensity, pharmacist-led collaborative intervention in primary care resulted in modest improvements in prescribing of disease-modifying medications but did not improve clinical outcomes in a population that was relatively well treated at baseline
Findings from a pilot randomised trial of an asthma internet self-management intervention (RAISIN)
<b>Objective </b>To evaluate the feasibility of a phase 3
randomised controlled trial (RCT) of a website (Living
Well with Asthma) to support self-management.<p></p>
<b>Design and setting</b> Phase 2, parallel group, RCT,
participants recruited from 20 general practices across
Glasgow, UK. Randomisation through automated voice
response, after baseline data collection, to website
access for minimum 12 weeks or usual care.<p></p>
<b>Participants </b>Adults (age≥16 years) with physician
diagnosed, symptomatic asthma (Asthma Control
Questionnaire (ACQ) score ≥1). People with unstable
asthma or other lung disease were excluded.<p></p>
<b>Intervention</b> Living Well with Asthma’ is a desktop/
laptop compatible interactive website designed with
input from asthma/ behaviour change specialists, and
adults with asthma. It aims to support optimal
medication management, promote use of action plans,
encourage attendance at asthma reviews and increase
physical activity.<p></p>
<b>Outcome measures</b> Primary outcomes were
recruitment/retention, website use, ACQ and mini-
Asthma Quality of Life Questionnaire (AQLQ).
Secondary outcomes included patient activation,
prescribing, adherence, spirometry, lung inflammation
and health service contacts after 12 weeks. Blinding
postrandomisation was not possible.<p></p>
<b>Results </b>Recruitment target met. 51 participants
randomised (25 intervention group). Age range
16–78 years; 75% female; 28% from most deprived
quintile. 45/51 (88%; 20 intervention group) followed
up. 19 (76% of the intervention group) used the
website, for a mean of 18 min (range 0–49). 17 went
beyond the 2 ‘core’ modules. Median number of logins
was 1 (IQR 1–2, range 0–7). No significant difference
in the prespecified primary efficacy measures of ACQ
scores (−0.36; 95% CI −0.96 to 0.23; p=0.225), and
mini-AQLQ scores (0.38; −0.13 to 0.89; p=0.136). No
adverse events.<p></p>
<b>Conclusions</b> Recruitment and retention confirmed
feasibility; trends to improved outcomes suggest use of
Living Well with Asthma may improve self-management
in adults with asthma and merits further development
followed by investigation in a phase 3 trial
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