Distribution and Character of Naleds in Northeastern Alaska

Satellite imagery and high- and low-altitude aerial photography of the North Slope of Alaska indicate that naleds (features formed during river icing) are widespread east of the Colville River but less abundant to its west. Where naleds occur, stream channels are wide and often braided. Their distribution can be related to changes in stream gradient and to the occurrence of springs. Large naleds, such as occur on the Kongakut River, often survive the summer melt season to form the nucleus of icing in the succeeding winter. Major naleds also are likely to significantly influence the nature of permafrost in their immediate vicinity. A map of naleds may serve as a guide to sources of perennially flowing water

Beyond Evaluation: Using the RE-AIM Framework for Program Planning in Extension

Extension professionals need to apply sound frameworks to program planning and evaluation in order to demonstrate strong population health impact and value. Pragmatic application of the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework addresses the who, what, when, where, how, and why of a program\u27s implementation. This article suggests pragmatic questions and example applications for each of the RE-AIM dimensions specifically for Extension professionals. This adapted RE-AIM tool can help Extension practitioners in all disciplines better plan and evaluate their programs and demonstrate the public value of Extension

Men's perceptions of the impact of the physical consequences of a radical prostatectomy on their quality of life

Objective: To identify men's perceptions of the impact of the physical consequences of a radical prostatectomy on their quality of life. Introduction: Prostate cancer is the most common male cancer and second most common cause of cancer death of men in the Western world. Compared to other prostate cancer treatments, trials report worse urinary incontinence and sexual function and similar bowel function among men with prostate-specific antigen detected prostate cancer who underwent radicalized prostatectomy. Inclusion criteria: This review included men of all ages and nationalities who had undergone a radical prostatectomy as treatment for any stage of prostate cancer. It considered studies that investigated: Inclusion criteria: Any setting where the topic was addressed with participants meeting the inclusion criteria was included. The review considered studies that focused on qualitative data including, but not limited to: phenomenology, grounded theory, ethnography and action research. Studies were included if they reported results relating to one or more of the phenomena of interest. Studies not written in English were excluded. Methods: The search strategy aimed to find published studies from six databases from database inception to November 2017. Methodological quality of studies was independently assessed by two reviewers using the standardized JBI Critical Appraisal Checklist for Qualitative Research. For data extraction, the standardized Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI) data extraction tool was used. A meta-aggregation was undertaken and the final synthesis of the findings was reached through discussion. Results are presented as five aggregated qualitative syntheses. Results: Nineteen qualitative studies were included in the review. The five synthesized findings were: Conclusions: Urinary incontinence and erectile dysfunction are significant side-effects of radical prostatectomy which have a negative impact on men's quality of life for which they feel ill prepared, and physical and psychosocial support is essential

Understanding how to facilitate continence for people with dementia in acute hospital settings: a mixed methods systematic review and thematic synthesis

Background People living with dementia (PLWD) are at significant risk of developing urinary and/or faecal incontinence and are also at risk of functional incontinence or being labelled as being incontinent. Despite the growing population of PLWD and importance of continence care, little is known about the appropriate management, organisation, and interactional strategies for PLWD admitted to acute hospitals. This mixed methods systematic review and thematic synthesis sought to identify successful strategies across all care settings that could then be used to inform innovations in continence care for PLWD in the acute hospital setting. Methods In phase 1, a scoping search of two electronic databases (MEDLINE and PsycINFO) and a consultation with stakeholders was undertaken. Findings were presented to the project steering group and two priority areas for phase 2 were identified which were communication and individualised care plans. In phase 2, eight databases and relevant UK government and other organisational websites were searched for English language citations from inception to August 2020. Critical appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT Version 11). Thematic synthesis was employed and the strength of synthesised findings for the intervention studies was assessed using the GRADE approach and the confidence in synthesised qualitative and survey findings was assessed using the CERQual approach. Results In phase 1, 1348 citations were found and 75 included. In phase 2, 6247 citations were found, 14 research studies and 14 policy and guidance documents were included. The quality of studies varied. Material was synthesised into three overarching syntheses which were: communication this is dignified, person-centred and respectful; communication during outpatients apointments and delivering individualised continence care. Conclusions Recognising that PLWD are not always able to communicate their continence needs verbally is important. Incorporating interpersonal and communication skills into the context of continence care within training for those working with this patient group is crucial for continence to be maintained during an acute admission. Continence care in the acute setting should be tailored to the individual and be developed in partnership with staff and caregivers

Relationship-centred care for people living with dementia in care homes

Dementia is a progressive degenerative disease, typically affecting older adults for which there is currently no cure. Dementia is characterised by progressive impairment to several cognitive functions including memory and orientation, practical abilities and mood changes, all of which can impact personality and social relationships. The theory of social death has been explored for people living with dementia as the ability to maintain social interactions are threatened leading to a loss of social identity and exclusion and withdrawal from the wider community. A relationship-centred care approach has been recommended to improve care for older people in long-term care, aiming to create environments conducive to relationships, considering the needs of the person living with dementia and also the staff and family members involved in their care. The ‘Senses Framework’ by Nolan was designed to promote relationships, acknowledging the experiences of all parties across six senses: security, continuity, belonging, purpose, fulfilment and significance. Utilising the Senses Framework has the potential to sustain meaningful relationships by fostering a sense of value and empowerment. This Rapid Evidence Summary aims to explore the evidence assessing the benefits of a relationship triad approach (Senses Framework and other relationship-centred care approaches) in long term care settings (including care homes) for people living with dementia. Nine primary studies and one systematic review were identified. The benefits of using a relationship-centred approach were mapped under each of the senses described within the Senses Framework, detailed separately for people living with dementia, relatives and care home staff. For people living with dementia, interventions using touch and music increased the sense of security and belonging reducing neuropsychiatric conditions such as agitation and aggression. Memory boxes were used to support a sense of significance and continuity and significant moments from the past brought pleasure and enabled meaningful conversations. For relatives and staff, improved communication and relationships increased confidence and trust and by working together they found that they could exert more influence and could develop into a powerful force for change

A rapid scoping review of harm reduction strategies for ecstasy (MDMA) users in recreational settings

Background: Adverse drug reactions (ADRs) can occur due to ecstasy use, and the number of people dying due to drug-related deaths has increased in the past 10 years. Harm reduction strategies could help prevent ADRs or decrease the incidence of life-threatening health consequences due to ecstasy use. However, no reviews have explored the breadth of evidence available on ecstasy harm reduction strategies. Methods: A rapid scoping review was conducted using adapted JBI methodology to identify the prevalence and nature of harm reduction strategies that ecstasy users employ in recreational settings, with both peer-reviewed research and user-oriented drug information websites explored. Five databases (CINAHL, EMBASE, Medline, PsycINFO, CENTRAL) were searched for English language records from database inception to August 2022. User-oriented websites were identified via the project’s stakeholder group and Google searches. Results: Twenty reports representing 19 studies (one randomised control trial, nine quantitative descriptive studies and nine qualitative studies) were included. A wide variety of harm reduction strategies were reported, including drug-specific strategies (for example, limiting the amount of ecstasy consumed, buying from trusted sources, drug checking (pill testing)); behavioural strategies (for example, monitoring fluid (water) consumption, taking a rest break to regulate temperature, avoiding alcohol and mixing with other drugs; preloading and post-loading); and peer-related strategies (for example not using alone, looking out for friends). Ecstasy users obtain information on ecstasy’s effects and/or harm reduction practices from a variety of sources including friends, nightclubs, TV news, drug leaflets, music magazines and user-oriented information websites. Fourteen user-oriented websites providing ecstasy-specific harm reduction information were identified, and strategies focused on dosage and frequency of use, interaction with other substances and prevention of health consequences, such as heatstroke, or dehydration among others. However, only two webpages provided citations to the evidence used for the content. Conclusions: While numerous harm reduction strategies exist, employing them can depend on the users’ overall goal/s which might also encompass avoiding comedown or increasing their high. Moreover, users’ previous experience can influence how and when they adhere to harm reduction. More efficient ways of communicating harms and harm reduction strategies might be needed

Inferring Parametric Energy Consumption Functions at Different Software Levels:ISA vs. LLVM IR

The static estimation of the energy consumed by program executions is an important challenge, which has applications in program optimization and verification, and is instrumental in energy-aware software development. Our objective is to estimate such energy consumption in the form of functions on the input data sizes of programs. We have developed a tool for experimentation with static analysis which infers such energy functions at two levels, the instruction set architecture (ISA) and the intermediate code (LLVM IR) levels, and re ects it upwards to the higher source code level. This required the development of a translation from LLVM IR to an intermediate representation and its integration with existing components, a translation from ISA to the same representation, a resource analyzer, an ISA-level energy model, and a mapping from this model to LLVM IR. The approach has been applied to programs written in the XC language running on XCore architectures, but is general enough to be applied to other languages. Experimental results show that our LLVM IR level analysis is reasonably accurate (less than 6:4% average error vs. hardware measurements) and more powerful than analysis at the ISA level. This paper provides insights into the trade-off of precision versus analyzability at these levels

γδ T cell responses: How many ligands will it take till we know?

γδ T cells constitute a sizeable and non-redundant fraction of the total T cell pool in all jawed vertebrates, but in contrast to conventional αβ T cells they are not restricted by classical MHC molecules. Progress in our understanding of the role of γδ T cells in the immune system has been hampered, and is being hampered, by the considerable lack of knowledge regarding the antigens γδ T cells respond to. The past few years have seen a wealth of data regarding the TCR repertoires of distinct γδ T cell populations and a growing list of confirmed and proposed molecules that are recognised by γδ T cells in different species. Yet, the physiological contexts underlying the often restricted TCR usage and the chemical diversity of γδ T cell ligands remain largely unclear, and only few structural studies have confirmed direct ligand recognition by the TCR. We here review the latest progress in the identification and validation of putative γδ T cell ligands and discuss the implications of such findings for γδ T cell responses in health and disease

Within-sibship genome-wide association analyses decrease bias in estimates of direct genetic effects

Estimates from genome-wide association studies (GWAS) of unrelated individuals capture effects of inherited variation (direct effects), demography (population stratification, assortative mating) and relatives (indirect genetic effects). Family-based GWAS designs can control for demographic and indirect genetic effects, but large-scale family datasets have been lacking. We combined data from 178,086 siblings from 19 cohorts to generate population (between-family) and within-sibship (within-family) GWAS estimates for 25 phenotypes. Within-sibship GWAS estimates were smaller than population estimates for height, educational attainment, age at first birth, number of children, cognitive ability, depressive symptoms and smoking. Some differences were observed in downstream SNP heritability, genetic correlations and Mendelian randomization analyses. For example, the within-sibship genetic correlation between educational attainment and body mass index attenuated towards zero. In contrast, analyses of most molecular phenotypes (for example, low-density lipoprotein-cholesterol) were generally consistent. We also found within-sibship evidence of polygenic adaptation on taller height. Here, we illustrate the importance of family-based GWAS data for phenotypes influenced by demographic and indirect genetic effects