Miracle-dz/UniFAR-FTUs huggingface dataset:
The determinants of informal caregivers' burden in the care of frail older persons: a dynamic and role-related perspective

ABSTRACT Research into informal caregivers’ burden does not distinguish between different stages of impairment. This study explored the determinants of burden from an in-depth perspective in order to identify which determinants apply to which phases of impairment. Methods: This was a cross-sectional study including frail older persons aged 65 and above. Instruments used were the interRAI Home Care, the Zarit-12 interview and an ad hoc economic questionnaire. A combination of variables from the Stress Process Model and Role Theory and a sub-group analysis enabled refined multivariate logistic analyses. Results: The study population consisted of 4175 older persons (average age: 81.4 ± 6.8, 67.8% female) and their informal caregivers. About 57% of them perceived burden. Depressive symptoms, behavioral problems, IADL impairment, previous admissions to nursing homes and risk of falls yielded significant odds ratios in relation to informal caregivers’ burden for the whole sample. These determinants were taken from the Stress Process Model. When the population was stratified according to impairment, some factors were only significant for the population with severe impairment (behavioral problems OR:2.50; previous admissions to nursing homes OR:2.02) and not for the population with mild or moderate impairment. The informal caregiver being an adult child, which is a determinant from Role Theory, and cohabitation showed significant associations with burden in all strata. Conclusion: Determinants of informal caregivers’ burden varied according to stages of impairment. The results of this study can help professional caregivers gain a greater insight into which informal caregivers are most susceptible to perceive burden. Abbreviations: NIHDI: National Institute for Health and Disability Insurance; ZBI12: Zarit Burden Interview - 12 items; InterRAI HC: interRAI Home Care instrument; ADL: Activities of Daily Living; ADLH: interRAI Activities of Daily Living Hierarchy scale; IADL: Instrumental Activities of Daily Living; IADLP: InterRAI Instrumental Activities of Daily Living Performance scale; CPS2: InterRAI Cognitive Performance scale 2; DRS: InterRAI Depression Rating scale
Sequential phases in the development of Aire‐expressing medullary thymic epithelial cells involve distinct cellular input

Intrathymic deletion of immature thymocytes that express self‐reactive TCR specificities is essential in the generation of self tolerance. Medullary thymic epithelial cells (mTEC) expressing the transcriptional regulator Aire play a key role in this process by regulating expression of tissue‐restricted antigens to ensure tolerance to peripheral tissues. Here, we have analysed the cellular and molecular requirements for the initial appearance of Aire+ mTEC in the embryonic thymus, in addition to their persistence in the adult thymus. Analysis of thymic ontogeny shows that the emergence of embryonic Aire+ mTEC occurs prior to the appearance of mature thymocytes, and depends upon lymphoid tissue inducer cells expressing retinoic acid receptor‐related orphan receptor γ. In the adult thymus, we show that Aire+ mTEC develop in the absence of thymocyte positive and negative selection and CD40 signalling, but are present at reduced frequency. Collectively these data support a model where the initial differentiation of Aire+ mTEC involves receptor activator of NF‐κB (RANK)‐RANKL interactions with lymphoid tissue inducer cells, with subsequent mTEC turnover and/or survival involving CD40‐mediated signalling following interactions with mature CD4+ thymocytes that express CD40L.
Interventions based on self-management of well-being theory: pooling data to demonstrate mediation and ceiling effects, and to compare formats

ABSTRACT Objectives: Interventions based on self-management of well-being (SMW) theory have shown positive effects, but additional questions remain: (1) Are improvements in well-being, as induced by the interventions, mediated by improved self-management ability (SMA)? (2) Do the interventions show ceiling effects? (3) Is a particular format of SMW intervention (individual, group, or self-help) more effective? Method: Data of three randomized controlled trials were pooled. The greater part of the sample (N = 445) consisted of single older females. A bootstrap analysis was performed to test for mediation. Regression analyses with interaction effects were performed to test for ceiling effects. Controlled and transformed effect sizes (proportion of maximum change) were calculated to compare formats. Results: There was a full significant mediation of well-being by SMA. A significant interaction (ceiling) effect was found on well-being, but not on SMA. The controlled effect sizes of the raw scores were small to medium (.04–.49), and were small to large after transformation (.41–.73). None of the intervention formats was more effective. Conclusion: Support for SMW theory was found, i.e. increasing self-management ability lead to improved well-being. Some ceiling effect was found. We conclude that various SMW interventions formats can improve self-management abilities and well-being with medium effects.
Autism spectrum disorders, attention deficit/hyperactivity disorder, and sleep disorders

Purpose of review There is increased awareness of sleep disorders and their complexity in developmental disorders, including autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD). This review is focused on the latest reports of research on sleep disorders in these two developmental disorders. Recent findings Sleep disruptions such as prolonged sleep onset latency, sleep fragmentation, and increased daytime sleepiness are repeatedly described in both ASD and ADHD. Parasomnias are common in ASD, but rarely studied in ADHD. Sleep disordered breathing and restless legs syndrome have been consistently associated with ADHD. Abnormal sleep architectures, including sleep fragmentation and rapid eye movement sleep abnormality, are reported in both ASD and ADHD. The impact of psychiatric comorbidity on sleep disorders is considered in recent studies. Summary Sleep disorders are common in both ASD and ADHD. Appropriate diagnosis and treatment of sleep disorders should improve daytime behaviors and well being of these individuals and their families. Further research on clinical characteristics and sleep architecture using well characterized and better-selected patient populations are warranted for both ASD and ADHD. Longitudinal study of sleep disorders and the treatment effects will provide a better understanding of the relationship between sleep disorders and the developmental disorders.
Patterns and Determinants of Breast Feeding Practices in Dodoma Municipality: A Cross Sectional Study

Promotion of proper breastfeeding practices for the first six months of life is the most cost-effective intervention for reducing childhood morbidity and mortality. The objective of the present study was to determine prevalence of EBF and understand the awareness of breast feeding practices among the women in Dodoma Municipality, central part of Tanzania. A cross-sectional study was conducted in Dodoma municipality, Tanzania in April to May 2011. Multiple sampling methods were applied in selection of a sample 200(women aged 15-42 years). A structured interview schedule was used to collect information of Mothers with infants aged 0 to 12 months on demographic characteristics, knowledge of EBF, and details regarding breast feeding practices since birth of their children to six months of life. The prevalence of EBF among women in Dodoma Municipality, Tanzania was 59%. Knowledge of EBF was relatively higher (89%) compared to the prevalence of EBF (59%). In total, majority(89%) of the women in study area had initiated breastfeeding in first one hour of delivery. Hospital deliveries (67.5%) higher than home deliveries in Dodoma municipality. Though exclusive breastfeeding prevalence rate found higher than at national level which was encouraging but not satisfactory according to world health organizations recommendations. Interventions and further research should address the low prevalence of exclusive breast feeding practices in study area.
Social health and dementia: a European consensus on the operationalization of the concept and directions for research and practice

ABSTRACT Background: Because the pattern of illnesses changes in an aging population and many people manage to live well with chronic diseases, a group of health care professionals recently proposed reformulating the static WHO definition of health towards a dynamic one based on the ability to physically, mentally and socially adapt and self-manage. This paper is the result of a collaborative action of the INTERDEM Social Health Taskforce to operationalize this new health concept for people with dementia, more specifically the social domain, and to formulate directions for research and practice to promote social health in dementia. Method: Based on the expertise of the Social Health Taskforce members (N = 54) three groups were formed that worked on operationalizing the three social health dimensions described by Huber et al.: (1) capacity to fulfil potential and obligations; (2) ability to manage life with some degree of independence; (3) participation in social activities. For each dimension also influencing factors, effective interventions and knowledge gaps were inventoried. After a consensus meeting, the operationalizations of the dimensions were reviewed by the European Working Group of People with Dementia (EWGPWD). Results: The social health dimensions could be well operationalized for people with dementia and are assessed as very relevant according to the Social Health Taskforce and EWGPWD. Personal (e.g. sense of coherence, competencies), disease-related (e.g. severity of cognitive impairments, comorbidity), social (support from network, stigma) and environmental factors (e.g. enabling design, accessibility) that can influence the person with dementia's social health and many interventions promoting social health were identified. Conclusion: A consensus-based operationalization of social health in dementia is proposed, and factors that can influence, and interventions that improve, social health in dementia identified. Recommendations are made for research and practice.
Social networks and alcohol use among older adults: a comparison with middle-aged adults

ABSTRACT Objectives: This study compared the association between social networks and alcohol consumption among middle-aged (MA) and older adults (OA) to better understand the nature of the relationship between those two factors among OA and MA. Method: We examined Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Current drinkers aged over 50 were subdivided into two age groups: MA (50–64, n = 5214) and OA (65 and older, n = 3070). Each age group was stratified into drinking levels (low-risk vs. at-risk) based on alcohol consumption. The size and diversity of social networks were measured. Logistic regression models were used to examine age differences in the association between the social networks (size and diversity) and the probability of at-risk drinking among two age groups. Results: A significant association between the social networks diversity and lower odds of at-risk drinking was found among MA and OA. However, the relationship between the diversity of social networks and the likelihood of at-risk drinking was weaker for OA than for MA. The association between social networks size and at-risk drinking was not significant among MA and OA. Conclusion: The current study suggests that the association between social networks diversity and alcohol use among OA differs from the association among MA, and few social networks were associated with alcohol use among OA. In the future, research should consider an in-depth exploration of the nature of social networks and alcohol consumption by using longitudinal designs and advanced methods of exploring drinking networks.
Incongruent perceptions of the care values of hospitalized persons with dementia: a pilot study of patient-family caregiver dyads

ABSTRACT Objective: Many difficult decisions are made in the inpatient hospital setting regarding the daily care of persons with dementia (PWDs). Incongruent perceptions of the PWD's care values limit the family caregiver's ability to make surrogate decisions. The objectives of this pilot study were to describe and identify determinants of incongruent perceptions in the hospital setting. Methods: Using multilevel modeling (MLM), we examined cross-sectional data collected from 42 PWD-family caregiver dyads. Results: There was a significant amount of incongruence, on average, for all four subscales representing the PWD's care values: autonomy = −0.33 (p < .001); burden = −. 49 (p < .001); safety/quality of care = −. 26 (p < .001); and social interactions = −. 21 (p = .004). Family caregivers (CG) rated the importance of care values to the PWD as lower than the PWD rated the importance. Determinants of greater incongruence included higher relationship strain and fewer positive dyadic interactions. Conclusion: Our findings reveal significant levels of incongruence in perceptions of the PWD's values among dementia care dyads in the hospital setting. Our analysis suggests a potential impact of relationship variables on incongruence. Further research is needed around this overlooked interpersonal context for supporting the dementia care dyad in the hospital setting.
Peripheral and Central Audiological Sequelae of Closed Head Injury: Function, Activity, Participation and Quality of Life

The aim of the present study was to analyse long-term effects of closed head injury (CHI) on peripheral auditory function, presence of central auditory processing disorders (APD), impairment, communicative function, activity and quality of life (QoL), including an evaluation of a new methodology (Acoustic Environmental Test, AET). From a total of about 600 patients with CHI of sufficient impact to cause fracture of the skull base and/or brain contusion, 66 patients had, in close proximity to the trauma, been evaluated with pure tone audiometry and 45 of these were in the present study evaluated 2–13 years after trauma. The design was focused on type of lesion and type of consequence. The initial classification of head injury was evaluated with computed tomography and the Swedish Reaction Level Scale (RLS). A standardized anamnesis was obtained from each subject. In all subjects, pure tone audiometry and distorted speech audiometry (interrupted speech, IS) were performed, and questionnaires regarding hearing, the Gothenburg profile, and regarding quality of life, EATS (Efficiency of Assistive Technology and Services) were administered. Eighteen subjects completed the AET in a specially designed acoustic environment room. There was also a focus on the ICF (international classification of functioning, disability and health) concept. Twenty-five cases had skull fracture only, nine cases fracture and brain contusion and 11 cases brain contusion only. There was a high prevalence of reported tinnitus (56%), vertigo (38%) and memory deficiencies (40%). Pure tone audiometry was significantly poorer in the trauma group than in a matched control group, and 32 subjects (71%) showed progress of ⩾15 dB at one or more frequencies. Twenty-eight subjects demonstrated pathological results on the IS. In the AET, four subjects had no problems with sound localization with a fixed sound source, but obvious problems in localizing a moving sound source. In general there was good agreement between self-assessments and test results, but there were also individual cases with considerable discrepancies. Peripheral hearing impairments, APD, cognitive deficiencies, tinnitus and vertigo are common long-term sequelae of CHI. APD and vertigo were more common among women. The new test method AET was able to demonstrate signs of binaural hearing deficiencies in a considerable number of cases with normal pure tone averages. Although there was generally good agreement between self-assessments and test results, some cases of pronounced differences were present. In particular, the attempt to apply ICF to these subjects highlights the importance of the individual's own evaluation of her or his situation.
Transcriptional re‐programming of primary macrophages reveals distinct apoptotic and anti‐tumoral functions of IRF‐3 and IRF‐7

The immunoregulatory transcriptional modulators – IFN‐regulatory factor (IRF)‐3 and IRF‐7 – possess similar structural features but distinct gene‐regulatory potentials. For example, adenovirus‐mediated transduction of the constitutively active form of IRF‐3 triggered cell death in primary human MΦ, whereas expression of active IRF‐7 induced a strong anti‐tumoral activity in vitro. To further characterize target genes involved in these distinct cellular responses, transcriptional profiles of active IRF‐3‐ or IRF‐7‐transduced primary human MΦ were compared and used to direct further mechanistic studies. The pro‐apoptotic BH3‐only protein Noxa was identified as a primary IRF‐3 target gene and an essential regulator of IRF‐3, dsRNA and vesicular stomatitis virus‐induced cell death. The critical role of IRF‐7 and type I IFN production in increasing the immunostimulatory capacity of MΦ was also evaluated; IRF‐7 increased the expression of a broad range of IFN‐stimulated genes including immunomodulatory cytokines and genes involved in antigen processing and presentation. Furthermore, active IRF‐7 augmented the cross‐presentation capacity and tumoricidal activity of MΦ and led to an anti‐tumor response against the B16 melanoma model in vivo. Altogether, these data further highlight the respective functions of IRF‐3 and IRF‐7 to program apoptotic, immune and anti‐tumor responses.
Impact of Event Scale Prediction of DSM-IV PTSD and Physical Symptoms in Gulf War Veterans

ABSTRACT This study examined the effectiveness of the Impact of Event Scale (IES; Horowitz, Wilner, & Alvarez, 1979) variables in detecting posttraumatic stress and physical symptoms in relevant groups of Gulf War veterans. A large sample of Gulf War veterans were administered the the IES, a semi-structured interview (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993) on DSM-IV (American Psychiatric Association, 1994) criteria for posttraumatic stress disorder (PTSD), and a Physical Symptom Questionnaire from the National Center for PTSD Patient Medical Information Checklist (1993). This study utilized four groups of veterans: 1) a reserve control group of participants who were in a reserve unit during the Gulf War but not deployed to the Gulf; 2) a Gulf War control group of veterans who were deployed to the Gulf War but did not report any symptoms of PTSD; 3) a subclinical group of Gulf War veterans who reported 1–5 DSM-IV criteria for PTSD; and 4) a group of Gulf War veterans who met DSM-IV criteria for PTSD. Group contrasts supported the hypothesis that IES scores would be significantly different in the expected clinical direction. Analyses also demonstrated significant relationships between IES scores and the number of DSM-IV symptoms of PTSD as well as the number of physical problems reported by these veterans.
Stress and emergency work experience: a non‐linear relationship

Emergency workers vary in their levels of experience, both in terms of years of service and involvement with traumatic incidents, and both types can influence vulnerability to stress. Opposing arguments can be made that experience has a sensitising or desensitising effect. Experienced emergency workers are shown to be more at risk in some studies and less so in others. It is proposed that the relationship between experience and stress is not necessarily linear, as is frequently assumed in such studies. This paper presents a test of linear and quadratic trends on stress and related variables across three groups of experienced firefighters. The results support the proposition that the relationship between stress and experience is quadratic, with stress highest in the middle experience group, and lowest in the low and high experience groups. This result is not explained by differences in actual traumatic exposures or coping practices. Other possible reasons are discussed.
Pervasive learning games: A comparative study

This paper investigates how pervasive games can be used for an efficient transfer of knowledge in learning situations. Pervasive games present an innovative game model which merges the real world and the virtual world. In the present study, this game concept is used in conjunction with mobile phones as a means of interaction and communication enablers to support learning. The paper presents the design of a new pervasive learning game, which was compared with a conventional case-study approach in an empirical study with 100 students in respect to long-term learning results and learning efficiency. The empirical results reveal that the pervasive game leads to higher energetic activation, more positive emotions, and more positive attitudes towards learning content, than the conventional case-study approach.
Hypertrophy, replicative ageing and the ageing process.

Two Letters to the Editor (Ganley et al ., 2012; Kaeberlein, 2012) have been published as a reaction to our commentary entitled ‘Hypertrophy hypothesis as an alternative explanation of the phenomenon of replicative ageing of yeast’ (Bilinski et al ., 2012). Our response to those letters, because of its limited length will concentrate only on the most important issues raised. The main experimental argument against the hypertrophy hypothesis was that ‘yeast mothers stop replicating with a range of sizes: enlarged, but not uniformly so’. This statement confirms that hypertrophy (enlargement) is observed also in other strains. Uniformity is rather rare in biology. The heterogeneity of the volume at which replication stops is a simple consequence of the molecular noise, important especially at the level of regulatory molecules whose copy number in a cell is very low (Di Talia et al ., 2007; Frigola et al ., 2012). The critical events in cell division are regulated by such molecules. The main point of controversy is not hypertrophy itself, but its origin. In one of the replies, it was stated ‘there is an implicit (and as yet untested) assumption: hypertrophy results from increasing cell cycle arrest’ (Ganley et al ., 2012). However, even if cells are not arrested, they …
Prevalence of different palatal rugae patterns in a sample Lucknow population

Introduction: Palatoscopy is the study of palatal rugae pattern and it can be used to establish the identity of a person. The rugae are unique internal structures protected by the lips, buccal pad of fat and teeth that resist decomposition, thus serving an important role in forensic identification. The appearance of palatal rugae is constant, as they do not demonstrate changes after the completion of growth of the individual, thus increasing its utility as a personal identification tool. Aims and Objectives: To study the prevalence of different palatal rugae patterns in a sample of Lucknow, India population. Materials and Methods: The study comprised 100 healthy (50 males and 50 females) subjects of age between 18 and 40 years, who were randomly selected. In this study we used the classification of rugae patterns suggested by Kapali et al. (straight, curved, wavy andcircular), and Thomas and Kotze (unification and nonspecific). Results: The mean rugae number in females was slightly more than males. The most prevalent forms in both genders were curved type followed by wavy, straight and diverging types. Straight and curved forms were significantly more in numbers in females than males. Conclusion: This is a preliminary study on a localized Indian population. Scope still exists for further studies to determine gender as well as personal identification. We believe that rugae can be used as a reliable guide in forensic identification.