bluuebunny/crossref_metadata_2025 huggingface dataset:
Black Women's Domestic Labor at Angola (Louisiana State Penitentiary) during Jim Crow
Authors: Rech Nathalie
Published: October 2022

On September 19, 1922, Beulah M., a thirty-year-old cook, saved a “small child from a vicious cow on Angola.” This event occurred only a few months after her admission to the Louisiana State Penitentiary (LSP), where she was serving a life sentence for alleged murder. The infant was one of the many of the white prison staff's children raised on the penitentiary plantation nestled in a large meander of the Mississippi river. This happy-ending drama featuring a Black woman prisoner and a free white child arose from the “cohabitation” of free white households within the incarcerated population. The incident, quite unexpected in a carceral setting, prompted the penitentiary general manager to place Beulah M. on the “eligibility list” for parole and to grant her “full single good time for meritorious service,” which meant the possibility of an earlier release by a few months. Beulah's action might also have motivated authorities to assign her to be “servant” in the Camp D Captain's house in July 1923, and later to be a nurse in the nine-bedroom “Big House,” occupied by one of the penitentiary staff of higher rank. The peculiar nature of her alleged crime, the beating to death of her seven-year-old Black step-daughter, was apparently not perceived as a deterrent to entrust her to care for white children. Her courageous action toward a white child at Angola might even have been a compelling argument for her early pardon and discharge, which she received only after nine years at Angola, although her plea for a pardon had been rejected at least once before. Beulah M.'s story is the story of a coerced African American domestic laborer in white homes, rewarded for her perceived subservience to the Jim Crow order. It exemplifies one aspect of Black women's experiences of hard labor for the state of Louisiana during the first half of the twentieth century.
Once they are seated: the impact of radical right parties’ political representation on attitudes of trust and solidarity
Authors: Larsen Mikkel Haderup
Published: October 2022

A close reading of the literature on radical right parties (RRPs) suggests that these parties erode trust and solidarity in European democracies when they pit ‘the pure people’ against political and legal institutions, elites, and immigrants. I propose the conjecture that RRPs with seats in the national parliament have better conditions for spreading nativist and populist messages that may erode trust and solidarity between a society’s residents, between ethnic groups, and towards its political and legal institutions. To test this research question, I combine nine waves of European Social Survey data from 17 countries and data on national elections spanning the years 1999 to 2020. Two-way fixed effects models estimate that RRPs representation in the national parliament is associated with a reduction in public support for redistribution of ca. 18% of a standard deviation. Additionally, I demonstrate that this inverse relationship runs parallel to growing welfare chauvinistic beliefs and that it is stronger in countries with weak integration policies. Contra theoretical expectations, the radical rights’ political representation has not produced any change in societal levels of anti-immigration attitudes, institutional trust, or social trust. While the findings persist across a wide range of robustness checks and other model specifications, threats to identification in the form of non-parallel pre-trends and unobserved sources of confounding, means that one should be cautious in interpreting the findings in a causal manner.
Linking Upper‐Plate Fault Reactivation With the Megathrust Earthquake Cycle: The Case of the Northern Chile Outer Forearc (19°S–23°S)
Authors: Cortés‐Aranda J. , González J. , Molina D. , Astudillo‐Sotomayor L. , Tassara A. , Miller M. , Álvarez‐Amado F. , González R. , Bahamondes D.
Published: October 2022

Crustal faults above subduction megathrusts have been shown to have the capacity to produce moderate‐to‐large earthquakes (fault reactivation), causing severe damage for inhabited areas in the vicinity. Fault reactivation has been dynamically related to the interseismic stage of the subduction cycle and to megathrust earthquakes. In the northern Chile outer forearc (19°S–23°S), published works have demonstrated that six faults of different orientation and kinematics produced M ∼ 7 paleoearthquakes during the Late Quaternary; these lie above the interplate rupture of the 1877 M8.7 Iquique Earthquake. Here, we assess the potential of these and similar faults to experience reactivation due to stress perturbations induced by the interseismic and coseismic phases of the megathrust earthquake cycle. To do so, we compute Coulomb Failure Stress changes (ΔCFS) produced by different megathrust locking/earthquakes (real and synthetic) scenarios. Our results show that fault reactivation is enhanced by both interseismic and coseismic stages. Furthermore, they suggest that reverse slip on EW and NS faults is favored during the interseismic stage; in turn, faults of different orientations and kinematics are favored following megathrust earthquakes. The easiest way to promote the reactivation of most of the considered faults is with interplate ruptures slipping within (but not necessarily restricted to) the seismogenic zone between 20°S and 23°S. These ruptures would augment the hazard from crustal faulting in the area. These results highlight the need to continue studying the paleoseismology of these faults and their dynamic link with the megathrust seismic cycle, in this and other subduction margins.
Estimating the Completeness Magnitude mc and the b‐Values in a Snap
Authors: Godano C. , Petrillo G.
Published: October 2022

A good estimation of the b‐value is crucial for the earthquake hazard assessment. Its evaluation can be strongly affected by an incorrect estimation of the completeness magnitude mc because a too small mc will reflect into a small b‐value, whereas a too large mc will imply a larger standard deviation due to the reduction of the magnitude interval. Several methods for the estimation of mc exist, however its evaluation is very delicate and requires some critical decision making in most cases. Here we present a new, very rapid and simple method for mc estimation. It is based on the observation that the Gutenberg‐Richter distribution is an exponential one only for magnitudes larger than mc. As a consequence, the average magnitude ma value should increase linearly with a threshold magnitude mth. The departures from such linear behavior, allows a correct estimation of mc, whereas the linearity of the of ma versus mth allows a correct estimation of the b‐value.
Tracking Water in the Tongan Volcano’s Massive Eruption Plume
Authors: Stanley Sarah
Published: October 2022

The recent eruption of the Hunga Tonga–Hunga Ha‘apai volcano blasted sulfate aerosols and a record-breaking amount of water vapor into the stratosphere.
Stalagmites Show Evidence of Prolonged Droughts in India
Authors: Averett Nancy
Published: October 2022

A new study using oxygen isotopes reconstructs a prolonged record of India’s summer monsoons, showing much greater variability than modern data sets.
Flow Visualization of Transition From Linear to Nonlinear Flow Regimes in Rock Fractures
Authors: Kim Dahye , Yeo In Wook
Published: October 2022

This study made the first experimental attempt to visualize the transition processes from linear to nonlinear flow regimes in rough‐walled rock fractures for a better understanding of the evolution of flow regimes in rock fractures. The experiments visualized the narrowing of the mainstream channel associated with eddies enlarged near the fracture wall with increasing applied flux. The measured fluid velocity field showed that these flow structures resulted in a significant increase in fluid velocity in the narrowed main flow channel and a relatively small velocity in the enlarged eddy zone. The order‐of‐magnitude analysis of local inertial and viscous forces, using measured fluid velocity vectors, showed that inertial forces overwhelmed viscous forces in the narrowed mainstream channel of rough‐walled segments, which led to the transition to nonlinear flow in rough‐walled fractures. The quantitative comparison between measured fluid velocity and the numerical simulations showed good agreement. This study demonstrates that the micro‐PIV technique can serve for phenomenon‐based experimental research on fluid flow and solute transport in rock fractures.
Improving Rainfall‐Runoff Model Reliability Under Nonstationarity of Model Parameters: A Hypothesis Testing Based Framework
Authors: Vora Anav , Singh Riddhi
Published: October 2022

Rainfall‐runoff models are used to project the impact of climate change on water resources. Often, models are parameterized over historical climate prior to simulating runoff under changed climates. An increasing body of literature indicates that this assumption of model parameter invariance to climate can introduce significant simulation biases as projected climate deviates from historical climate. One way to consider the effect of climate on model parameterization is to regionalize model parameters using historical data and use that information to project parameters’ probable distribution under a changed climate. These approaches, termed trading space‐for‐time (TSFT), have shown promising results when simulating mean annual runoff, but their ability to reproduce time varying daily runoff response remains unexplored. Here, we design experiments to identify possible ways to account for the influence of climate on model parameters by building upon a recently developed Whittaker‐biome‐based TSFT framework. We perform 35 experiments, each representing different hypotheses regarding how model parameters may be altered with climate. We test these hypotheses for seven watersheds across the conterminous United States that undergo significant climate change between 1980–1990 and 1999–2009. Our results show that updated parameters for the best experiment increased median Nash–Sutcliffe Efficiency for the two most climate‐impacted watersheds in our analyses from 0.37 to 0.35 to 0.64 and 0.49, respectively. Improvements in simulation performance for watersheds transitioning from the boreal forest and the woodland/shrubland biomes to the temperate seasonal forest biome were attributed to altered snow and routing parameters, respectively.
Chromobacterium Csp_P biopesticide is toxic to larvae of three Diabrotica species including strains resistant to Bacillus thuringiensis
Authors: Pereira Adriano E. , Huynh Man P. , Paddock Kyle J. , Ramirez José L. , Caragata Eric P. , Dimopoulos George , Krishnan Hari B. , Schneider Sharon K. , Shelby Kent S. , Hibbard Bruce E.
Published: October 2022

The development of new biopesticides to control the western corn rootworm (WCR), Diabrotica virgifera virgifera LeConte, is urgent due to resistance evolution to various control methods. We tested an air-dried non-live preparation of Chromobacterium species Panama (Csp_P), against multiple corn rootworm species, including Bt-resistant and -susceptible WCR strains, northern (NCR, D. barberi Smith & Lawrence), and southern corn rootworm (SCR, D. undecimpunctata howardi Barber), in diet toxicity assays. Our results documented that Csp_P was toxic to all three corn rootworms species based on lethal (LC50), effective (EC50), and molt inhibition concentration (MIC50). In general, toxicity of Csp_P was similar among all WCR strains and ~ 3-fold less toxic to NCR and SCR strains. Effective concentration (EC50) was also similar among WCR and SCR strains, and 5-7-fold higher in NCR strains. Molt inhibition (MIC50) was similar among all corn rootworm strains except NCR diapause strain that was 2.5–6-fold higher when compared to all other strains. There was no apparent cross-resistance between Csp_P and any of the currently available Bt proteins. Our results indicate that Csp_P formulation was effective at killing multiple corn rootworm strains including Bt-resistant WCR and could be developed as a potential new management tool for WCR control.
An Exploratory Investigation of the Palatoglossus Muscle in Children Using Magnetic Resonance Imaging
Authors: Power Samantha , Kotlarek Katelyn J.
Published: October 2022

Purpose:

There is currently little evidence reporting the typical morphology of the palatoglossus (PG) muscle. The primary purpose of this exploratory study is to determine whether magnetic resonance imaging (MRI) methods used to quantify the morphology of the levator veli palatini (LVP) muscle can be applied to the PG. The secondary purpose is to provide preliminary data regarding the relationship between the LVP and PG muscles in children.

Method:

Ten children between ages of 4 and 7 years participated in this study. Each participant was scanned using a nonsedated, child-friendly protocol with a T2-weighted, three-dimensional anatomical scan to obtain images of the oropharyngeal anatomy. Custom, oblique-coronal image planes were created to visualize and measure the LVP and PG muscles in their entirety from origin to insertion. Thermo Scientific Amira Software was used to obtain 2D measurements of PG muscle length, width, velar insertion distance, lingual insertion distance, and several angle measurements.

Results:

The PG ranged from 17.95 to 26.96 mm in length across participants. Velar insertion distance ranged from 17.22 to 30.95 mm. Lingual insertion distance ranged from 26.91 to 36.02 mm. Width ranged from 2.32 to 3.08 mm. The angle formed by the PG and LVP muscle planes ranged from 7.3° to 52.7°. The LVP insertion angle ranged from 42.5° to 75.9°. The PG insertion angle ranged from 16.9° to 52.3°.

Conclusions:

MRI was successful in visualizing the PG muscle. The PG was consistent in size and shape within an individual participant but varied across the participant cohort.
General wellbeing and work impacts among community pharmacists during crisis management
Authors: Khalil Hanan , Liu Chaojie , Karimi Leila , Ferrier J. Adamm , Liang Zhanming , Leggat Sandra
Published: October 2022

Background Community pharmacists are highly accessible for advice, as most pharmacies are open long hours and no appointment is needed. Community pharmacists, as essential community health workers, play a critical role in the fight against coronavirus disease 2019 (COVID-19). This study aimed to determine the general wellbeing and work impacts of pharmacists and the factors important for adaptability and resilience during the COVID-19 pandemic. Methods This study adopted a cross-sectional design. Community pharmacists from various professional networks in Australia were invited through emails and social media posts to complete an anonymous online survey during the second wave of the COVID-19 pandemic in Victoria, Australia. Results Sixty-five community pharmacists completed the online survey. The respondents reported fair levels of general wellbeing during the COVID-19 pandemic, with a mean self-related health score of 33.57 (s.d. = 13.19) out of a maximal of 96, despite relatively high levels of job stress and emotional labour. Lower levels of general wellbeing were correlated with higher levels of job stress (r = 0.645, P < 0.01) and emotional labour (r = 0.513, P < 0.01), and lower levels of occupational self-efficacy (r = −0.566, P < 0.01). Leader member exchange was negatively correlated with job stress (r = −0.419, P < 0.01) and positively correlated with psychological safety (r = 0.693, P < 0.01). The linear regression models showed that female pharmacists had lower occupational self-efficacy (β = −0.286, P = 0.024), but higher psychological safety (β = 0.234, P = 0.042). Higher work ability was associated with lower job stress (β = −0.529, P < 0.001), higher occupational self-efficacy (β = 0.511, P = 0.001), and poorer self-related health (β = −0.659, P < 0.001). Conclusions The findings highlight the importance of a supportive work environment in helping community pharmacists to feel psychologically safe and reduce stress during a crisis.
What women want from local primary care services for unintended pregnancy in rural Australia: a qualitative study from rural New South Wales
Authors: Noonan Anna , Black Kirsten I. , Luscombe Georgina M. , Tomnay Jane
Published: October 2022

Background Under the generalist model of health care in rural Australia, general practitioners (GPs) are often the first point of contact for women seeking health services for unintended pregnancy, including pregnancy decision-making support and options advice, antenatal or abortion care. Rural women are more likely to experience unintended pregnancy in Australia, yet little is known about how well local rural primary healthcare services currently meet their needs. Methods To address this gap, this qualitative study explores through in-depth semi-structured interviews, the experiences of 20 rural women managing an unintended pregnancy, and their expectations of, and satisfaction with, the quality of care they received. The Framework Method was used to organise data and conduct an inductive thematic analysis. Results Three themes related to management of unintended pregnancy in a rural primary care setting were identified: (1) women expect informed and efficient care once services are reached; (2) women desire greater choice and aftercare; and (3) comprehensive reproductive health should be part of rural primary care. Participants indicated an awareness of the limitations of the rural health system, yet a firm expectation that despite access delays, all of their reproductive health needs would be met. Choice, time efficiency, and aftercare were identified as gaps in the current primary care service experience. A desire for greater attention to rural reproductive health, including improved contraception, was also emphasised. Conclusions Rural women with unintended pregnancy experienced gaps in service quality and described a lack of woman-centred care in their local rural health setting. This study offers insight into how rural primary care providers can better support women to make decisions about and reach their preferred services for unintended pregnancy.
Social-identity dynamics in rural communities: a motive for resistance to change
Authors: Ham Saleena
Published: October 2022

This research found that rural social resistance to change and newcomers can be explained in part by the influence of social-set membership. Eighty-nine interviews were conducted in two Australian inland rural communities with population <2000 and analysed with a recognised cultural dynamics framework. This found attachment to local social identity, social hierarchy and cultural norms that represented social power. Established residents defended the status quo when valued facets of social identity were perceived to be threatened, resisting efforts to introduce change. Persons representing a challenge to established local identity norms could be socially undermined and censured to preserve the power of dominant social sets, defending their preferred narratives and norms. Understanding social identity influences can explain rural communities’ tendency to conservatism, why newcomers and new ideas are often derided, ignored or attacked. It can explain the motives for negative social capital and suggests social identity as a factor in small town newcomer business failure, and resistance to new knowledge transfer and practice adoption. Welcome and induction to local social codes is critical to newcomer integration. Outsiders and newcomers may meet discretely with like-minded or similar persons to safely fulfil social needs or influence as a social minority, providing support to their own unique group. Where residents cannot find inclusion, they may disengage. Understanding social identity can provide insights for community leaders, development practitioners, extension officers and newcomers struggling to serve and innovate in rural and rangelands communities.
Is meaning construction attempted during the processing of pseudo-compounds?
Authors: Cruz Karen Pérez , Patel Chelsa , Steinbach Jazlynn , Barre Mohamed , Kibbins Holly , Wong Dixie , Taikh Alexander , Gagné Christina L. , Spalding Thomas L.
Published: October 2022

Psycholinguists have yet to reach a consensus on what role constituent morphemes play in the processing of
compound words, although some recent work suggests that morphemes are activated obligatorily during processing. In the current
study, we investigate whether people use morphemes to attempt meaning construction even for pseudo-compounds which are words that
appear to have a compound structure, but in fact do not (e.g., carpet is not car + pet). We
obtained relational entropies (a measure of potential relational competition) for a set of pseudo-compound words based on
responses from a possible relations task. The relational entropy values as well as frequency of the prime (e.g.,
carpet) and target (e.g., car) were then used to predict the processing of the pseudo-first
constituents after exposure to the pseudo-compound masked primes. We observed a significant three-way interaction between entropy,
target frequency, and prime frequency. Our results suggest that meaning construction is attempted for pseudo-compound words.
The role of referent cohesiveness in variable subject expression in L2 Spanish
Authors: Linford Bret , Geeslin Kimberly
Published: October 2022

This study examines the development of variable subject expression in Spanish across multiple proficiency levels of second-language learners. We employ a cross-sectional design and a written contextualized task in order to explore the differences in rates of subject forms as well as the degree to which factors related to referent cohesiveness constrain the acquisition of subject expression. We include a group of native speakers from the same community of practice for comparison. Our results suggest that, although learners appear to acquire native-like rates of subject forms, this process takes several years. Additionally, the rates of selection of forms were similar for the native speakers and the most advanced non-native speakers, but there remained important differences between these groups across the categories of the referent cohesiveness variable. Finally, we show that the various factors used to operationalize referent cohesiveness do not influence subject expression uniformly.
Role of stacking fault on mechanical properties of a DS alloy
Authors: Rai R. K.
Published: October 2022

In the present study, a novel strengthening mechanism that does not impair the plasticity has been ascertained in a directionally solidified nickel-based superalloy (DS alloy) during monotonic and cyclic deformations. The alloy exhibited excellent mechanical properties at 750°C. Sub-structural examinations revealed that the activation of the stacking fault-induced micro-twinning mechanism is responsible for the improved fatigue performance at 750°C. This work may lead us to design advanced nickel-based superalloys having good synergy of strength and plasticity for turbine blade applications.
Preprint Highlight: A role for phase separation to prevent R-loops during transcription
Authors: Zhang Huaiying
Published: October 2022

The RNA-binding protein FUS (FUSed in sarcoma) regulates transcription by binding to polymerases and undergoing phase separation to enrich transcription machinery and RNA processing factors. Using an in vitro transcription assay and a DNA-dependent RNA polymerase from T7 phage (T7 Pol) that does not bind to FUS, this study uncovered a polymerase-binding independent role of FUS in increasing transcription productivity. The ability of FUS to phase separate with RNA prevented RNA-DNA hybrid (R-loop) formation during transcription in vitro and in cells. This work suggests a potential link between the toxicity of FUS mutants in amyotrophic lateral sclerosis or Ewing sarcoma to elevated R-loops and the resulting disruption in gene expression and genome stability.
10 ASSISTED DECISION-MAKING, THE OLDER ADULT, AND LOCUS OF CONTROL
Authors: Dowling T , Kennedy S , Foran S
Published: October 2022

Background

The Assisted Decision-making (Capacity) Act (ADMCA) (2015) will be fully commenced later in 2022. At its core, the legislation seeks to encourage the older adult to express their will and preferences regarding their healthcare decisions. The legislation removes healthcare decision-making powers from family members and healthcare professionals unless expressly nominated by the patient to make decisions on their behalf. However, a lack of clarity and professional uncertainty pervades this area in Ireland that is mirrored in the global research.

Methods

This qualitative study comprised 5 focus groups of hospital discharge coordinators in the South East of Ireland. It sought to examine the issues that exist for the older patient when they return home following a hospital stay. It also examined who really has responsibility for healthcare decision-making and who is responsible for providing the care? Thematic analysis was used to analyse the findings.

Results

The findings revealed a significant incongruence of beliefs among patients, family members and healthcare professionals when it comes to locus of control.

Conclusion

This study’s findings on locus of control – both in terms of where the discharge coordinators believe the locus is, and where they believe the families think it is - are the first of their kind in Irish Healthcare and are therefore highly significant in several respects. The substantive areas of disagreement in beliefs among the groups, represent real barriers to supporting ADMCA going forward.
12 VACCINATION UP-TAKE IN DERMATOLOGY PATIENTS OVER THE AGE OF 65 YEARS ON BIOLOGICAL TREATMENT
Authors: Egan A , Farrell A , Byrne B , Lynch M
Published: October 2022

Background

Biologic and immunosuppressive therapies play important roles in the management of a wide variety of dermatologic diseases. However, immunotherapies can negatively affect normal immune functioning, placing these patients at high risk of infection. The strength of the immune system also declines with increasing age. Thus, in accordance with the British Association of Dermatology guidelines (August 2021), patients taking biologic therapy can and should have their covid, influenza and pneumococcal vaccinations.

Methods

We conducted a retrospective audit of all patients over the age of 65 years on biological therapy in the dermatology clinic between March 2021 to March 2022. Data on patients covid, influenza and pneumococcal vaccination status was obtained from Dermatology database and patients medical records.

Results

A total of 18 patients over the age of 65 years, were on biological therapy in the Dermatology Department, between March 2021 to March 2022. The mean age was found to be 71 years with a standard deviation of 5.2 and there was equal gender distribution. 94% (n=17) of patients had psoriasis and 6% (n=1) had eczema. With regards to biological treatments, 17% (n=3) of patients were on Adalimumab,11% (n=2) on Etanercept and 28% (n=5) on Cosntyx. 100% (n=18) had all three of their covid-19 vaccines. 50% (n=8) are awaiting their 4th covid vaccination. 94% (n=17) of patients had their influenza vaccine. 66% (n=12) had their pneumococcal vaccination, the patients who had not had their pneumococcal vaccination were recommended and advised to have it.

Conclusion

This audit confirms dermatology patients over the age of sixty-five years, are compliant on receiving their covid vaccinations, as recommended by the BAD. However, only 66% of patients had their pneumococcal vaccination and 94% had their influenza vaccine, illustrating the need for educational intervention on the importance of vaccination. This will then be followed by a reaudit next year to complete the audit cycle.
15 FRAILTY AND ADVERSE OUTCOMES IN HIP FRACTURE PATIENTS
Authors: Small C , Sullivan R , O'Hanlon S , Cooney M T , Doyle R
Published: October 2022

Background

Frailty is highly prevalent in older hip fracture patients, conferring greater risk of poorer outcomes including increased Length of Stay (LOS), Nursing Home (NH) placement and mortality

Methods

This prospective observational study took place in a large university hospital with a daily trauma list and an established orthogeriatric service. We compared 3 different screening tools; Rockwood Clinical Frailty Scale (CFS), Zuckerman’s Functional Recovery Score (FRS) and New Mobility Score (NMS) and their ability to predict outcomes in hip fracture patients. Participants included all hip fracture patients (>/= 60 years old) admitted to the orthopaedic ward from 2016-2018. Scores were assigned by an ortho-geriatrician and were analysed at admission and at 1 year.

Results

Increasing frailty scores were associated with increased mortality, LOS and NH admission rates. Those with a CFS of 4-6 had an increased risk of mortality compared to those with a CFS of 1-3 (OR:3.81, CI 2.15-6.76). Those with a CFS of 7-9 demonstrated increased risk of mortality compared to those without frailty (OR: 8.75, CI 4.58-16.72). Patients with mild-moderate frailty (CFS 4-6) were 5 times more likely to require NH at 1-year (OR 5.09, CI 3.03-8.56) and those with severe frailty (CFS 7-9) were 7 times more likely to be in a NH at 1-year (OR 7.03, CI 3.82-12.94). The moderate frailty group had an inpatient stay 16 days longer than the non-frail group and the severe frailty group, 26 days longer than the non-frail group. Results were similar for FRS and NMS and when adjusted for age. Comparing the discrimination of the different measures for predicting survival, analysis of receiver operating characteristic curves revealed - 0.73 (CFS), 0.72 (NMS) 0.74 (FRS). Interestingly, the mortality rate for men was 32% compared to 21% for females (OR: 1.75 p=0.005).

Conclusion

Assessing frailty with a standardised protocol could reliably estimate the risk of adverse outcomes in hip fracture patients.
16 SARS-COV-2 INFECTION AND VACCINATION PATTERNS DETERMINE LONG-TERM ANTIBODY RESPONSES IN NURSING HOME RESIDENTS: DATA FROM NH-COVAIR
Authors: Dyer A , Noonan C , Reddy C , Garcia L , Batten I , McElheron M , Roche N , Connolly E , Boran G , White M , Pelleau S , Leonard A , O'Neill D , Fallon A , O'Farrelly C , Bourke N , Kennelly S
Published: October 2022

Background

Older Nursing Home Residents (NHRs) are at greatest risk of morbidity and mortality from SARS-CoV-2, particularly in the context of both waning vaccine efficacy and the emergence of Variants-of-Concern (VOCs). However, the determinants of long-term vaccine-induced protective antibody responses are yet to be determined in this group.

Methods

NH-COVAIR recruited older NHRs for comprehensive clinical and frailty (NH-FRAIL) assessment. Blood samples were obtained pre-vaccination, at 6-weeks and 6-months following primary vaccination and 6-months following booster vaccination. Antibody titres were measured using both an electrochemiluminescence assay and a custom bead-based array (Luminex™) to measure antibody titre and avidity for Wuhan strain/major VOC antigens. Stepwise adjusted linear regression (log-transformed) assessed longitudinal determinants of vaccine-induced antibody responses.

Results

Of 86 participants (81.1 ± 10.8 years; 65% female), just under half (45.4%) had evidence of previous SARS-CoV-2 infection. All NHRs mounted a significant antibody-response to vaccination at 5 weeks followed by a significant decrease in antibody titre by 6 months. Previous SARS-CoV-2 infection was the strongest predictor of antibody waning at all timepoints (β: 3.59; 2.89, 4.28; P < 0.001 for 6-months). Independent of infection history, both age (β: –0.05; –0.08, –0.02; p<0.001) and frailty (β: –0.22; –0.33, –0.11; p<0.001) were associated with faster antibody waning at 6-months. Cross-reactivity and avidity were significantly lower for Beta (B.1.351) and Gamma (P.1) VOC strains (all p<0.001). Additionally, there was faster antibody waning and significantly reduced antibody avidity to Beta and Gamma VOCs in SARS-CoV-2 naïve NHRs.

Conclusion

Older NHRs are capable of mounting protective antibody responses to SARS-CoV-2 vaccination. Responses were more durable, with a greater cross-reactivity to and avidity for VOCs in those with previous SARS-CoV-2 infection. Increasing age and greater frailty in NHRs was associated with faster antibody waning. Our findings support ongoing serological surveillance and use of additional vaccine doses in older NHRs, particularly in those without previous SARS-CoV-2 exposure.
17 CROSS-SECTIONAL AND LONGITUDINAL RELATIONSHIPS BETWEEN MOBILITY, NEUROPSYCHOLOGICAL PERFORMANCE AND FALLS IN COMMUNITY-DWELLING OLDER ADULTS: DATA FROM TUDA
Authors: Dyer A , Dolphin H , Laird E , Hoey L , McNulty H , Hughes C , Ward M , Strain JJ , O'Kane M , Tracey F , Molloy A , Cunningham C , McCarroll K
Published: October 2022

Background

Impaired mobility is associated with incident cognitive impairment and dementia. However, the complex bi-directional temporal relationships between subtle impairments in neuropsychological performance, mobility trajectories and falls is poorly understood.

Methods

Using data from the Trinity, Ulster Department of Agriculture (TUDA/TUDA5+) study, we evaluated cross-sectional and longitudinal relationships between impaired mobility, neuropsychological performance and falls using regression models adjusted for important clinical confounders. Older adults with potential cognitive impairment (Mini-Mental State Examination score <25) were excluded. Detailed neuropsychological assessment was performed using the RBANS (Repeatable Battery for Neuropsychological Assessment) and FAB (Frontal Assessment Battery). Impaired mobility was assessed using Irish population-specific age/sex/height-specific Timed-Up-and-Go (TUG) cut-offs.

Results

Of 4,103 participants (72.9 ± 7.9 years; 67.4% female), just under one-fifth (17.5%) met criteria for impaired mobility. Older adults with impaired mobility had significantly greater likelihood of impaired neuropsychological performance, in particular for language (OR 1.77; 1.35-2.31; p<0.001) and attention (OR 1.69; 1.37-2.08; p<0.001) domains. In 953 participants followed for a median 5.2 (IQR: 4.83-7.26) years, impaired mobility at baseline significantly predicted incident impairment in immediate memory (OR 2.56; 1.33-4.95; p<0.001). Stronger relationships were seen for impaired neuropsychological performance predicting mobility decline rather than impaired mobility predicting cognitive decline (all p<0.001). Both impaired mobility and neuropsychological performance were associated with incident falls, particularly for impairments in executive function and attention (all p<0.001). Impaired mobility in isolation had poor performance as a sole test to predict incident cognitive impairment (AUC: 0.55-0.65).

Conclusion

In both cross-sectional and longitudinal analyses, impaired mobility is associated with subtle impairments in neuropsychological performance. Whilst impaired neuropsychological performance was a greater predictor of impaired mobility rather than vice versa, our findings highlight the complex relationship between mobility and cognitive trajectories in older adults, emphasising the need for comprehensive cognitive and falls assessment in those presenting with new-onset subtle impairments in mobility and cognition.
21 ASSESSING SARCOPENIA, FRAILTY AND MALNUTRITION IN COMMUNITY-DWELLING DEPENDANT OLDER ADULTS – A HOME-BASED STUDY WITH AN UNDERREPRESENTED GROUP IN RESEARCH
Authors: Swan L , Martin N , Warters A , O'Sullivan M
Published: October 2022

Background

Sarcopenia, frailty, and malnutrition are known determinants of adverse health outcomes. Adults of advanced age, with functional dependency, socioeconomic disadvantage, or a need for home care, are expected to be at high risk of these conditions yet are likely to be underrepresented in research. We aimed to examine the feasibility and preliminary outcomes of conducting home-based assessments in this group.

Methods

Home-based health assessments were conducted among older adults (n= 31), in receipt of state-funded home care. Assessments included probable sarcopenia [hand-grip strength (HGS), chair rise-test and SARC-F case-finding tool] in line with the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines, the Mini Nutritional Assessment (MNA), and the Clinical Frailty Scale (CFS).

Results

The study group was of mean age 83.2 ± 8.2 years, 74% female, 23% lived in socioeconomically disadvantaged areas, had comorbidities (n=30, 97%) and low physical activity (71%). We found that almost all met the criteria for probable sarcopenia (94%, 29/31), most were frail or vulnerable by CFA (97%, 30/31), and over a quarter were at risk of malnutrition (26%, n=8). In all participants, it was feasible to assess sarcopenia (by HGS and SARC-F, but not chair rise test), malnutrition (MNA), and frailty (CFS). Notably, in-home assessments required additional time, the adaptation of assessment tools, responsibility to address issues arising, including signposting to health services (36%, n=11), and navigating complex psychosocial environments; the latter was commonly observed in areas of socioeconomic disadvantage.

Conclusion

Assessing sarcopenia, frailty, and malnutrition in community-dwelling dependant older adults in-home was feasible, once potential challenges were considered. Moreover, our findings suggest that most participants were at risk of both sarcopenia and frailty, and over a quarter were at risk of malnutrition. This highlights a need for further research and proactive evidence-based multi-modal community interventions to support ageing in place.
22 KNOWLEDGE AND ATTITUDES OF UNDERGRADUATE OCCUPATIONAL THERAPY STUDENTS TOWARDS OLDER ADULTS WITH DEMENTIA
Authors: Gavin L , O'Callaghan L-J , Usher R
Published: October 2022

Background

Given the increasing prevalence of dementia within Ireland, there is a need to prepare future occupational therapists to work with older adults with dementia. This study aims to explore the knowledge and attitudes of undergraduate occupational therapy students in Ireland towards older people with dementia and related factors such as year of study, personal and placement dementia experiences, and future career choice.

Methods

A cross-sectional online survey, incorporating the Alzheimer's Disease Knowledge Scale and the Dementia Attitudes Scale, was used to gather data, which was analysed using descriptive and inferential statistics.

Results

In total, 75 survey responses were analysed. Results indicate that while dementia knowledge increases as occupational therapy students progress through their undergraduate degree, their dementia attitudes were not positively impacted. Placement experience with older adults with dementia did not affect either dementia knowledge or attitudes, while personal experiences had a significant positive influence on students' attitudes towards older adults with dementia. Among study respondents, the likelihood of selecting a future career with older adults with dementia was positively correlated with more positive dementia attitudes but remained unaffected by levels of dementia knowledge.

Conclusion

Older adults with dementia are a growing population in Ireland, resulting in a need to adequately prepare occupational therapy students to effectively fill positions in this expanding area of healthcare, by ensuring they have high levels of dementia knowledge and positive attitudes towards clients with dementia. This study found that while dementia knowledge increases with progression in an undergraduate occupational therapy degree, there is not a corresponding improvement in attitudes, an area that requires urgent attention. The results of this study indicate a need to further examine and develop Irish undergraduate occupational therapy programmes and incorporate additional dementia-focused learning opportunities, such as volunteering or service-based learning.
23 CO-DESIGNING A PRIMARY-CARE INTERVENTION TO REVERSE FRAILTY AND BUILD RESILIENCE THROUGH PUBLIC AND PATIENT INVOLVEMENT WITH OLDER PEOPLE
Authors: Travers J , Romero-Ortuno R , Cooney M-T , Shé É Ní
Published: October 2022

Background

An essential consideration in health research is to conduct research with members of the public rather than for them. Public and Patient Involvement (PPI) of older people in research can improve enrolment, relevance and impact. However, few studies with PPI in frailty research have been identified. PPI has fallen during the Covid-19 pandemic. We aimed to involve older people in co-designing a Randomised-Control Trial (RCT) intervention to reverse frailty and build resilience. We also wished to encourage wider use of PPI with older people by outlining our approach.

Methods

Involvement of older people was undertaken in three stages. Eighteen over 65-year-olds helped co-design an exercise intervention in two group discussions using the Socratic education method. Ninety-four contributed intervention feedback in one-on-one telephone interviews over nine months. Ten contributors helped optimise the intervention in three online workshops. Multidisciplinary team input and systematic review supported co-design.

Results

Eleven home-based resistance exercises were co-designed by group discussion contributors (mean age 75, 61% female). Frailty intervention format, gender balance and GP follow-up were shaped in telephone interviews (mean age 77, 63% female). Dietary guidance and patient communication were co-designed in workshops (mean age 71, 60% female). Technology proved no barrier to PPI. The co-designed frailty intervention is being evaluated in a definitive RCT.

Conclusion

We enabled meaningful involvement of 112 older people in co-design of an intervention to reverse frailty and build resilience in diverse ways. Inclusive involvement can be achieved during a pandemic. Feedback enhanced intervention feasibility for real-world primary-care.
24 REVERSING FRAILTY AND ENHANCING RESILIENCE WITH EXERCISE AND DIETARY EDUCATION (REFEREE): A PRIMARY CARE RANDOMISED CONTROLLED TRIAL
Authors: Travers J , Romero-Ortuno R , Langan J , MacNamara F , McCormack D , McDermott C , McEntire J , McKiernan J , Lacey S , Doran P , Power D , Cooney M-T
Published: October 2022

Background

There is a need for effective primary-care interventions that help older people combat frailty and build resilience. This study aims to test the effectiveness of a co-designed exercise and dietary protein intervention.

Methods

This was a multicentre, randomised-controlled, parallel-arm trial in six Irish primary-care practices. We enrolled adults aged 65+ with Clinical Frailty Scale score ≤5 from December 2020 to April 2021. Participants were randomised to intervention or usual care with allocation concealed until enrolment with a GP. Intervention comprised exercises, emphasising strength, and dietary protein guidance. At three-month follow-up, effectiveness was measured by comparing SHARE-Frailty Instrument between groups, on intention-to-treat basis. Secondary outcomes included muscle mass, bone mass and biological age measured by Bioelectrical Impedance Analysis (BIA). Ease of intervention and health difference were measured on Likert scales.

Results

359 adults were assessed for eligibility and 168 enrolled. 156 (92.9%) attended follow-up (mean age 77.1; 67.3% women; 79 intervention, 77 control). At baseline, frailty proportions were 17.7% in the intervention and 16.9% in the control group. At follow-up, they were 6.3% and 18.2%, respectively. The odds ratio (OR) of being frail for the intervention group was 0.23 times that of the control group (95% confidence interval: 0.07-0.72; P=0.011), adjusting for age, gender and site. Absolute risk reduction was 11.9% (CI: 0.8%-22.9%; P=0.018). Number needed to treat was 8.4. BIA parameters improved, bone mass significantly (P=0.040). 66.2% found the intervention easy, 69.0% reported feeling better.

Conclusion

A combination of exercises and dietary protein significantly reduced frailty and improved self-reported health. Frailty was reversed in more than 1 in 9 participants.
27 ASSOCIATIONS BETWEEN ORTHOSTATIC BLOOD PRESSURE BEHAVIOUR AND PROGRESSION OF AGE-RELATED MACULAR DEGENERATION IN THE IRISH LONGITUDINAL STUDY ON AGEING (TILDA)
Authors: Connolly E , Doyle SL , Kenny RA , Romero-Ortuno R
Published: October 2022

Background

Age-Related Macular Degeneration (AMD) is a progressive disease and the leading cause of vision loss in over 50’s in developed countries. Age-related changes in the neuro-cardiovascular system, at times manifesting as exaggerated blood pressure drops on standing (orthostatic hypotension) may be associated with end-organ damage. The aim of this study was to examine if the pattern of recovery of blood pressure upon standing from a supine position (orthostatic blood pressure behaviour), was associated with progression of AMD.

Methods

We utilised data from TILDA participants who had AMD at the wave 1 health assessment and returned for retinal image grading during the wave 3 health assessment, four years later. Beat-to-beat BP data was measured non-invasively by digital photoplethysmography (Finometer® MIDI) during the wave 1 Active Stand (AS) test. Measures recorded during AS included Systolic (SBP) and Diastolic (DBP) blood pressure. Associations between systolic and diastolic orthostatic BP behaviour and AMD progression were examined using generalised linear models (GLM). Baseline characteristics were compared between progression groups with the 2-samples Mann-Whitney U test and the Chi-squared test.

Results

Of the 191 included participants, 46 (24%) were found to have progression of AMD, while 145 (76%) had no change or regression of the disease. GLMs revealed no significant differences in SBP orthostatic behaviour across groups. However, those with AMD progression had lower orthostatic DBP values (tests of between-subjects effects p=0.005), particularly between 30-60 seconds post-stand (AMD progression: 72±10mmHg vs. No AMD progression: 79±12mmHg; p<0.001). Of the baseline participant characteristics considered, only age was associated with AMD progression (AMD progression: 66±8yrs vs. No AMD progression: 62±9yrs; p=0.005).

Conclusion

In this sample of TILDA participants with AMD, lower orthostatic DBP values were associated with AMD progression over four years. Reduced orthostatic diastolic perfusion may be a novel modifiable risk factor for AMD progression.