bluuebunny/crossref_metadata_2025 huggingface dataset:
Biology and Genetics of Human Longetivity
Authors: Baggio Giovannella , Franceschi Claudio , Mari Daniela , Herskind A.M. , Andersen‐Ranberg Karen , Jeune Bernard
Published: December 2008

Abstract. Human longevity is a multifactorial trait, which includes a network of genes combined with strong environmental factors. Biological and clinical characteristics of human beings are the result of the interaction between genes and the environment. Until about 1950 centenarians were quite rare in low‐mortality countries. Since then the number has more than doubled every 10 years and even the number of 105+ year old people is now increasing. This proliferation of centenarians is mainly a result of the decrease in oldest‐old mortality and probably due to changes of lifestyle and health care. Although studies of Danish twin pairs seem to indicate that genetic influence on human lifespan is only moderate, several gene loci contribute to longevity. Data are evident from the Italian Centenarian Study for apoproteinB, tyrosine hydroxylase and mitochondrial DNA loci among others studied (superoxide dismutases, ie. SOD1 and SOD2, poly(ADP‐ribose)polymerase and thyroid peroxidase). The data from the Danish Centenarian Study confirm the findings from the studies of French and Finnish centenarians on apolipoprotein E genotype with a higher frequency of epsilon‐2 and lower frequency of epsilon‐4. However, the apoE genotype seems not to be a key determinant of exceptional longevity: in 105+ year olds the epsilon‐4 allele was found in 4 out of 19 persons. Italian centanarians have a paradoxically marked hypercoagulability as demonstrated also by genetic markers. Also the von Willebrand factor was increased independently of the blood group. Studies on such atherosclerosis risk factors as lipoprotein(a) and homocysteine revealed that these two parameters may be high in Italian centenarians, but their genetic control possibly attenuates with age, and environmental factors may play a major role in the oldest‐old persons. Also interaction among genes is possible. All these studies suggest that longevity is a phoenomenon depending on multiple genetic and environmental factors. Further studies are needed for a better understanding of the complex interactions which allow people to reach a very old age.
Exploring the Experience of Ageing: an Overview
Authors: Bytheway Bill , Coleman Peter G.
Published: December 2008

Abstract. This overview represented both psychological and sociological approaches to the study of the experience of ageing from four north western European nations. The psychological presentations emphasised the importance of developing reliable and valid assessment instruments of the way people integrate their various states of awareness. The use of sentence completion Stems provided one method. Integrated stories were a further important way in which persons represented their lives, and needed to be studied in terms appropriate to the story. The sociological studies considered both theory making and different uses of the term ‘;experience’ in the gerontological literature. The hypotheses of an ageless self underlying an ageing body were disputed from the findings of a large survey. The last presentation emphasised the concept of learning from experience, and the importance of precedence for gaining a sense of being ‘;experienced’.
Action on Elder Abuse: an Overview
Authors: Daichman Lia S. , Wolf Rosalie A. , Bennett Gerald , Penhale Bridget , Podnieks Elizabeth
Published: December 2008

Abstract. The purpose of the symposium was to provide an international overview of the issues concerning action on elder abuse and neglect. Living longer is both an achievement and a considerable risk. It affects unprecedented opportunities, but it also presents personal and social challenges related to quality of life in old age. Essential questions were raised about dependency, autonomy, frailty and competence, and the controversial relationship between the elderly and those who care and sustain them in the community. Links between national findings and experiences, similarities and differences were discussed and possible ways forward were covered. Recognition of the dimension of what is a dominant societal jeopardy is still difficult and interventions do not always produce satisfactory outcomes. Awareness of the problem and early and planned actions are likely to be successful in limiting the impact of elder abuse.
Nursing Research Improving Practice: a Review
Authors: Garratt Sally
Published: December 2008

Abstract. This paper offers a review of the papers presented during the Nursing Research Improving Practice symposium and a synopsis of the issues that arose from the discussion following the symposium. Some of these will have an impact on future directions for nursing research in aged care, and seem to be applicable world wide. The idea for the symposium came from the knowledge that there is an increasing need to articulate the research base for nursing practice, to explain what nurses do and to advance the discipline as a major contributor to health care delivery. Unfortunately the research‐practice gap seems to be still alive and well in Australia and feedback from colleagues from other countries indicates they have the same problem.
Pain in the Elderly
Authors: Helme Robert D.
Published: December 2008

Abstract. Pain increases in prevalence from early adult years to approximately 60 years. Thereafter it seems likely that pain complaint reaches a plateau and may even decline in extreme old age. Pain in older people is demonstrably different to that experienced in younger adults, but if all the dimensions of the pain are recognised, it can be treated as effectively.
Comparative National Policies on Care and Support of Older Persons
Authors: Kane Robert L.
Published: December 2008

Abstract. This symposium focused on four developed nations: the US, Australia, Canada and Germany. Activities in each country were analysed along the following lines: What is the official policy with regard to income guarantees (national pension programs), medical care and/or medical insurance, long‐term care and housing? How well are the policy goals expressed in legislation being met? What is the extent of variation in services across the country? What factors are associated with high and low levels of service? To what extent are these services viewed as universal entitlements vs. linked to welfare status? How are economic and demographic forecasts affecting discussions about the future of these programs?
Molecular Biology of Ageing: Age‐associated Attenuation in the Regulation of the Expression of Stress Response Genes
Authors: Keidar Danit , Efrati Edna , Elaad Shlomit , Shamovsky Ilya , Weinreb Orly , Lavie Lena , Gershon David
Published: December 2008

Abstract. The attenuation in the capacity to respond to stress is one of the major characteristics of ageing organisms. There are several cellular pathways of response to various types of stress. We briefly discuss the NFkB pathway that is altered with age as was primarily shown by Papaconstantinou. We suggest that another important transcription factor system that should be investigated is that involved in the response to hypoxia. Our own work shows that the capacity to respond to elevated temperatures is considerably diminished in ageing organisms. Our studies demonstrate that this is due to faults in the control of the activation of the transcription factor, HSF, which is a major protein that activates many stress response genes. The nature of the alteration of the control of HSF with age is described and discussed.
Total Quality Management and Geriatric Care
Authors: Miller Douglas K. , Coe Rodney M. , Morley John E. , Gettman Jennifer
Published: December 2008

Abstract. For numerous reasons it is essential that geriatric practitioners become involved in improving the care delivered to older patients in all clinical settings. One of the more promising approaches to enhancing care for older persons is the set of techniques and philosophy embodied in the Total Quality Management (TQM) method. To develop an agenda for improving the quality of care delivered to older persons, we surveyed over 1,600 geriatric practitioners and asked 38 experts in geriatric care and quality improvement (QI) to respond to a series of questionnaires. Findings resulted in suggested approaches to improving care in four delivery sites (office, home, acute hospital nursing home). Of note, the experts strongly favoured the newer QI methods such as TQM over traditional approaches such as Medicare Review and Minimum Data Set. Potential next steps to improve QI methods in geriatric care are outlined, use of TQM in office practice and nursing homes is reviewed, and examples of successful TQM programs in these settings are described.
Older People as Social Pioneers
Authors: Warnes Anthony M.
Published: December 2008

Abstract. The five papers examined reveal diverse responses among older people to social and economic change. The main themes were: the changing accommodation and care needs of older people in urban areas as customary forms of family‐based support are compromised; the strength and resourcefulness of family obligations in managing support and care; and similarities and contrasts in private sector and governmental responses to needs. In Sao Paulo, Brazil, the inventiveness of families in establishing networks of support and in contriving physical aids to patients with paralysis is impressive. In the rural areas and townships of South Africa, the strength of family ties is revealed in the readiness of social‐benefit recipients to support others. In Ontario, Canada, several thousand retirees have responded to the marketing of vacated housing in a collapsed mining town; and in the Basque Country,‐ the older residents of new supported housing have few regrets about not living with their children but worry that others see them as recipients of charity. Around the Mediterranean, increasing numbers of retirees from several northern European countries are exploring new ways of developing mutual help, of pressing the authorities and businesses for better services, and seeking a resolution between their ethos of self‐responsibility and how to help those who cannot help themselves. Change is endemic, and constructive and assertive responses from older people are widely seen.
A Lavender Pink Grey Power: Gay and Lesbian Gerontology in Australia
Authors: Harrison Jo
Published: December 2008

Objective: A small exploratory qualitative study investigated key political activists' predictions regarding the process by which gay and lesbian older people will be included in aged care policies in the future in Australia.

Method: In‐depth semi‐structured interviews were conducted with six activists in aged care and human rights.

Results: Findings are discussed in relation to three broad themes: barriers to change; who should do what?; and strategies for success.

Conclusions: The study points to predictions about gay and lesbian aged policy which warrant further attention. It identifies a need for further research which investigates aspects of the findings, particularly the collaborative process between gerontologists and gay and lesbian activists. Such a process may lead to policies which emphasise social justice and the recognition of diversity in gerontology.
Further Validation of “Timed Up and Go” in Stroke Patients
Authors: Nair B. , Dobson A. , O'Dea I. , Hogben K. , D'Este K. , Page J.
Published: December 2008

Objective: To compare the Barthel Index (BI), a well‐known and accepted measure of functional disability, with Timed Up and Go (TUG).

Method: Thirty‐three stroke patients had their BI and TUG assessed by independent blinded observers.

Results: There was good agreement between BI and TUG, with good repeatability.

Conclusion: Thus TUG is a good measure of function pre‐discharge but needs to be further validated on more disabled patients.
Long‐term Health Consequences of Wartime Imprisonment: A Review of the Concord Hospital POW Project
Authors: Dent O.F.
Published: December 2008

Abstract. A project was commenced in 1982 to examine the impact of the stress of imprisonment on the post‐war physical and mental health of members of the Australian Army who had been captured by the Japanese at the fall of Singapore in 1942 (POWs). Comparison with a control group of combatants in the same theatre of war who had not been imprisoned showed very few differences in physical health but markedly higher psychiatric morbidity among the POWs. A second wave of the study in 1991 explored hypothesised links between dietary deprivation and severe stress as a young adult and the incidence of Alzheimer's dementia in later life but found no evidence of diminished cognitive performance among the POWs. Imprisonment as a risk factor for accelerated age‐related illness and disability was also examined but very few differences were found between the POWs and non‐POWs and those differences were relatively small. However the prevalence of anxiety and depressive disorders declined significantly between the first and second waves of the study, more so in the POWs than in the controls. An examination of several aspects of family life showed no differences between the POWs and non‐POWs, indicating that marital relationships had not been adversely affected by imprisonment.
The Charles Bonnet Syndrome
Authors: Lefroy Richard B.
Published: December 2008

Abstract. The history is reported of a person who fitted the description of the Charles Bonnet syndrome, a condition that was first described many years ago and largely ignored until recently. Although it has been suggested that the syndrome might be a marker for development of dementia, it warants consideration in an elderly person who presents with low vision and hallucinations.
Participation in Physical Activities by Older Australians: a Review of the Social Psychological Benefits and Constraints
Authors: Patterson Ian , Chang Milan
Published: December 2008

Abstract. Participation in physical activities has been found to be an important factor in contributing to a healthy lifestyle. Research has found strong relationships between participation in regular physical activity and the prevention of disease, while its relationship to the psychological and social dimensions have been neglected. Recently however, several studies have found causal relationships between physical activity and improved mood state, reduced anxiety, reduced depression, and increased social support. Despite this, surveys indicate that participation levels in physical activities are declining among older Australians, with the exceptions of walking and gardening. This paper also examines constraints to participation in leisure programs, such as lack, of time, poor health, fear of crime, the financial cost and the lack of a partner to participate with. A number of strategies have been suggested to overcome these constraints.
Setting the Pace: the Response of Non‐Government Organisations to the International Year of Older Persons
Authors: Sargeant Delys
Published: December 2008

Abstract. Planning for the International Year of Older Persons began in 1995. This paper overviews the way the Australian Coalition 99 ‐ a coalition of non‐government organisations ‐ was generated and has developed. It outlines some of the benefits of the Year and includes personal reflections by the author, herself an ‘;old’ woman.
The Importance of Home Visits: a Case of Extreme Polypharmacy
Authors: Lim Wen Kwang , Mason Janis
Published: December 2008

Abstract. In the US, the number of home visits or house calls has been declining. In Australia, it remains an extremely useful method by which to perform a comprehensive assessment of an older patient. We describe the case of a patient who presented with falls and cognitive decline due to polypharmacy which was only diagnosed by performing a home assessment.
Coordination and Elder Abuse: Development of Inter‐Agency Protocols in New South Wales
Authors: Sadler Paul , Sorensen Glen
Published: December 2008

Abstract. Improving coordination is a key concern for aged and community care services. Dealing with abuse, neglect and exploitation of older people requires effective coordination between agencies. This paper reviews the implementation of the NSW Inter‐Agency Protocol and the development of local protocols, using existing service provision systems, via a statewide training program. The protocol development process is an example of moving agencies from informal collaboration to formal coordination processes. The training program was successful and the local protocols provide flexibility to utilise the full range of providers and professional skills through the appointment of assessment teams including the most appropriate members from local agencies. There are weaknesses to this approach, including difficulties involving all key agencies in the protocol development and its reliance on busy existing providers and an incomplete service infrastructure. The effectiveness of the protocol in addressing individual cases of abuse requires further examination.
Effects of Pet Ownership on the Health and Well‐being of Older People
Authors: Wells Y. , Rodi H.
Published: December 2008

Objective: To examine the view that having a pet is good for the health and well‐being of older people, particularly those who are socially isolated.

Method: Benefits and disadvantages of owning a pet were explored in two studies. Data from the Health Status of Older People project were used to compare the health, health behaviours and well‐being of those who owned and did not own pets. In addition, twenty older people were interviewed in‐depth about pet ownership and its impact on their lives.

Results: Few health or well‐being outcomes were predicted by pet ownership. Having a pet did not compensate for social isolation. The qualitative data largely substantiate and provide possible explanations for the survey findings.

Conclusion: Pets may have some limited value in promoting health and well‐being in older people.
A Case of Sporadic Creutzfeldt‐Jakob Disease in an Older Chinese Woman
Authors: Wong Alfred K. W. , Chan Daniel K. Y.
Published: December 2008

Abstract. Creutzfeldt‐Jakob disease (CJD) is a rare but fatal transmissible neurodegenerative disease. There are relatively few reported cases among Chinese in the literature. This case report describes a case of sporadic CJD in an older Chinese woman.
The Impact of Neurodegenerative Disorders on Ageing: an Overview of the Sydney Older Persons Study
Authors: Creasey H. , Waite L.M. , Grayson D.A. , Bennett H.P. , Dent O. , Broe G.A.
Published: December 2008

Abstract. This paper reviews the Sydney Older Persons Study, a longitudinal study following an initial cohort of 630 subjects aged 75 and over, community living in the inner west region of Sydney, carried out over seven years in four waves from 1991. We discuss the epidemiology of neurodegenerative disorders (NDDs) in relation to: each other, systemic disorders, death, lifestyle, risk factors and their impact on quality of life, service use and carers.
Clinical Diagnosis and Disability Among Community Dwellers Aged 75 and Over: The Sydney Older Persons Study
Authors: Waite Louise M. , Creasey Helen , Grayson David A. , Edelbrock Dorothy , Cullen John S. , Brooks William S. , Casey Barney J. , Bennett Hayley P. , Broe G. Anthony
Published: December 2008

Objectives: Disability is an important predictor of health and community service utilisation. Understanding its pathogenesis has implications for planning of future health services. The aim of our study was to examine the contribution of systemic, psychiatric and neurodegenerative diseases to disability in an “old‐old” population.

Methods: 647 men and women over the age of 75 participated in the Sydney Older Person's Study. Disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and mobility was assessed using self report, informant and clinician assessments. Diagnoses of systemic, psychiatric, neurodegenerative diseases were made by clinicians. Individual disease contribution to disability was assessed using multiple regression analysis. Contribution to disability by the groups of systemic, neurodegenerative and psychiatric diagnoses was assessed, using hierarchical regression. Results: Neurodegenerative diseases were the major contributors to ADL impairment. Systemic and psychiatric diseases played a role in IADL and mobility impairment, as did the neurodegenerative diseases. Of the neurodegenerative diseases, dementia/cognitive impairment and Parkinsonism/gait slowing particularly contributed to disability. Self‐report under‐identified the role of the neurodegenerative diseases in disability. It also introduced a gender effect, that the clinical measures did not share to the same extent.

Conclusions: Neurodegenerative diseases are important contributors to disability and assessments and diagnosis of neurodegenerative diseases should be included in disability assessments. Self report under‐identifies the importance of these conditions.
Strategies Against Polypharmacy and Inappropriate Medication ‐ Are they Effective?
Authors: Chan FHW , Pei CKW , Chiu K C. , Tsang EKW
Published: December 2008

Objectives: To evaluate the effectiveness of a drug rationalization programme in reducing the incidence of polypharmacy and inappropriate medication since an initial survey performed in the previous year. Method: A retrospective case notes study was performed on patients discharged from the medical! geriatrics wards during the period from 1st of July 1997 to 30th of September 1997. This was exactly one year after the initial study followed by the implementation of a drug rationalization programme. Data collection was carried out by the same two medical staff using a data collection sheet. Data collected included patient's sex, age, length of stay, diagnoses, medication on discharge (whether appropriate or inappropriate) and adverse drug reactions (ADRs).

Results: The total number of cases was 210. 39.5% of cases were male while 60.5% were female. The mean age was 80.2 years (min. 59 and max. 103). The mean length of stay was 22.72 days (min. 2 and max. 148). The mean number of active and inactive diagnoses on discharge was 0.69 and 3.36 respectively. The mean number of medication on admission was 4.65. The mean number of inappropriate medication on admission was 0.50 per patient. The number of patients with inappropriate medication(s) on admission was 73 (34.8% of patients) with 10.86% of all medications prescribed on admission being inappropriate. The mean number of medication on discharge was 3.56, and the mean number of inappropriate medication was reduced to 0.13 per patient. The number of patients with inappropriate medication(s) on discharge was reduced to 26 (12.4% of patients) with 3.62% of all medications prescribed on discharge being inappropriate. The most frequent class of inappropriate medication was drugs for the respiratory system both on admission and discharge at 35.5% and 48.2% respectively. The commonest reason for being an inappropriate medication was the use of drug, which had no apparent indication both on admission and discharge at 70.2% and 50% respectively. There were 16 incidences of ADRs found in 15 patients (min. 1, max. 2 and mean of 0.076 per patients).

Conclusion: This study had demonstrated the effectiveness of our drug rationalization programme. The percentage of inappropriate medication on discharge was significantly reduced from the previous study's 18.03% to this study's 3.62%. The percentage of inappropriate medication was also reduced from 10.86% on admission to 3.62% on discharge in this study. Education of physicians, as well as patients, is much needed.
Rituals of visiting people with dementia in residential care
Authors: Schofield Verna
Published: December 2008

Objectives
: Visiting a family member with dementia in residential care can be an unpredictable and stressful experience, particularly in the early days of admission and little is known of how carers lessen their distress during this time.

Method
: A qualitative study of 25 family carers was carried out in which the carers were interviewed on three occasions for more than a year from shortly after their relative entering residential care. Three carer focus groups were also undertaken.

Results
: Many family carers developed routines in their visiting that indicated five different forms of ritual: repetitive visiting patterns, formalised elements to visits, symbolic caregiving, reward giving and visit reframing. These routines helped carers manage the experience of visiting. From the accounts of family members, residential staff often seemed unaware of the significance of the rituals and unknowingly discouraged them.

Conclusion
: These findings suggest that visiting involves complex processes that are insufficiently understood and their value underestimated. Strategies are discussed for assisting family carers to sustain their visiting practices. Further research is needed in this area to provide guidance for family members and those working in residential care. Key words: Dementia, ritual, residential care, caregiving, visiting, relationships, communication
Advocacy and ageing
Authors: Sorensen Harry , Black Barbara
Published: December 2008

Advocacy sounds like a complex and esoteric process, and 1 am not sure if the word means much to the lay person. However, in reality it is likely that each one of us has acted as an advocate in some sense. Simply defined, advocacy is ‘an act of pleading for, supporting or recommending’ (The Macquarie Dictionary, 1988, p. 70) the cause of another person. In general terms, an advocate is someone who ‘pleads a case’, who takes the side of another person or group of people and represents their interests. Advocacy is essentially the very ordinary process of standing up for the rights of others who are being unfairly treated (Parsons, 1994). Lawyers, unions and human service workers all act as advocates in the course of their work, as do the rest of us in everyday life.
Old people ought to be explorers: The questions of value
Authors: Brady Dr Veronica
Published: December 2008

It is appropriate that our theme this afternoon is ‘driving change’. It is evident that our society is addicted to, some would say afflicted by, change and that older people, like everyone else are caught up in the process. It may be also that many of us who grew up in more stable, less dynamic times find it more difficult to deal with. My argument, however, is that we should not. That at least is the import of the quotation from Eliot's Four Quartets which gives me my title:

Old men ought to be explorers Here and there does not matter We must be still and still moving Into another intensity. (Eliot, 1948: 22).
Grey nomads and grey voyagers
Authors: Westh Steve
Published: December 2008

‘After six years of making films whose subjects have been ‘older people’ 1 have come to the conclusion that if there is such a thing as ‘old age’ it must refer to that final brief period when body and mind shut down and death is imminent. Everything before that is just living.

IMPLICATIONS OF AN AGEING POPULATION 5–7 SEPTEMBER 2000

HYATT REGENCY HOTEL PERTH, WESTERN AUSTRALIA

Thematic Keynote Highlights

2000 FULBRIGHT SYMPOSIUM IMPLICATIONS OF AN AGEING POPULATION

Thematic Keynote Highlights

editors:

Ruth Marquis

Don Cameron

Richard Hugman

Duncan Boldy

Freemasons Centre for Research into Aged Care Services

Curtin University of Technology

GPO Box U1987, Perth, Western Australia, 6845

Telephone: 08 9266 7993 Facsimile: 08 9266 2508

Email: B.J.Hornerfgi.curtin.edu.au
The interface of acute and aged care: the role of the nurse in a provincial area
Authors: Hegney Desley , McCarthy Alexandra , de la Rue Mary Beth , Gorman Don , Martin‐McDonald Kris , Fahey Paul , Prett Grace
Published: December 2008

Objective: This study was to investigate issues that arose from pre‐admission to post‐discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the latge amount of data collected during this project, that is, the role of the nurse in the continuum of health care involving elderly people.

Method: The study involved a multi‐site, multi‐agency and multi‐method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients.

Results: The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post‐acute discharge.

Conclusion: The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.
The host‐homes program: an innovative model of respite for carers of people with dementia
Authors: Holm Sonya , Ziguras Stephen
Published: December 2008

Objective: To investigate the operation of an innovative community respite program run by the Brotherhood of St Laurence: the Banksia ‘host‐home’ program, which was designed to provide respite for up to six people with dementia in a care‐worker's home. The program was funded by the Commonwealth Department of Health and Aged Care as part of a funding program for pilot respite care projects.

Method: Interviews were conducted with program staff, carers and care‐recipients (older people with dementia). Information from written records such as funding submissions was also used.

Results: People using the program were those who experienced barriers utilising centre‐based programs for older people for a range of reasons including advanced dementia, hearing difficulties, difficulties in social interaction or confusion. Carers were very appreciative of the service, and care‐recipients appeared to enjoy the program immensely, citing caring staff, social contact and activities as things they appreciated most.

Conclusions: The host‐home program provided an accessible respite option for those unable to use centre‐based services. It enabled more individually tailored activities, greater socialisation and greater attention from staff than possible in centre‐based services. The informal ‘homely’ feel of the program and the fact that relatives obviously enjoyed participating may have made carers feel more comfortable in using a respite service. Since the model creates the potential for cost‐shifting and because of difficulties in supervising staff in their own homes, guidelines and standards appropriate to host‐home programs should be established to ensure quality of care and to protect paid staff and service users.
Increased Sexual Dysfunction in Men with Storage and Voiding Lower Urinary Tract Symptoms
Authors: Morant Steven , Bloomfield Glenys , Vats Vasudha , Chapple Christopher
Published: December 2008

Introduction

Sexual dysfunction (SD) and lower urinary tract symptoms (LUTS) are highly prevalent in men and increase with age. Previous studies have shown that LUTS and SD are highly associated in men, but most have not distinguished between voiding and storage LUTS.

Aims

Assess impact of voiding and storage LUTS on recorded diagnosis of SD in men in U.K. general practice.

Methods

Identified records of patients with SD and storage (e.g., overactive bladder) and voiding LUTS (e.g., benign prostatic hyperplasia) from a population-based study using The Health Improvement Network database with records from 333 general practices. Study period was 2000–2007; study population was men aged ≥ 18 years.

Main Outcome Measures

Prevalence rates of SD, and storage and voiding LUTS on January 1 of each year from 2000 to 2007.

Results

Overall prevalence of recorded SD rose from 1.7% in 2000 to 4.9% in 2007. The prevalence of storage and voiding LUTS also increased. Median age at diagnosis was 60 years for erectile dysfunction (ED), 62 years for other SD, 62 years for storage LUTS, and 61 years for voiding LUTS. Compared to men with no LUTS, odds ratios (95% CI) for ED were as follows: storage LUTS, 3.0 (2.6–3.4); voiding LUTS, 2.6 (2.4–2.7); and both voiding and storage LUTS, 4.0 (3.4–4.8). Among the 11,327 men with any recorded LUTS and ED at the beginning of 2007, LUTS diagnosis preceded SD in 63.1% of patients by a mean of 4.8 years.

Conclusions

Prevalence of SD was significantly higher in the presence of either storage or voiding LUTS compared to men with no recorded LUTS. The diagnosis of LUTS preceded SD in the majority of cases. Further research into the interrelationships between functional problems of the genitourinary tract may have implications for current treatment approaches and future therapeutic developments.
Metabolic and Antihypertensive Effects of Combined Angiotensin Receptor Blocker and Diuretic Therapy in Prediabetic Hypertensive Patients With the Cardiometabolic Syndrome
Authors: Zappe Dion H. , Sowers James R. , Hsueh Willa A. , Haffner Steven M. , Deedwania Prakash C. , Fonseca Vivian A. , Keeling Lucy , Sica Domenic A.
Published: December 2008

Hypertensive patients with the cardiometabolic syndrome (CMS) are at increased risk for type 2 diabetes and cardiovascular disease. The authors examined effects of valsartan and hydrochlorothiazide (HCTZ) combined and alone on insulin sensitivity (using homeostasis model assessment–insulin resistance [HOMA‐IR]), and inflammatory/metabolic biomarkers in prediabetic hypertensive persons with CMS. Eligible patients entered 16‐week therapy with valsartan 320 mg/d (n=189), HCTZ 25 mg/d (n=190), or valsartan/HCTZ 320/25 mg/d (n=187). At the end point, there were no statistically significant differences in HOMA‐IR among the 3 groups. HCTZ significantly increased hemoglobin A1c and triglyceride concentrations and lowered serum potassium levels vs valsartan. HCTZ also increased plasma aldosterone and C‐reactive protein levels. Blood pressure reduction and blood pressure control rates were highest with valsartan/HCTZ. There were no differences between combination valsartan/HCTZ or monotherapies on a measure of insulin sensitivity; however, the negative metabolic effects of HCTZ (increase in triglyceride and hemoglobin A1c values) were absent with valsartan/HCTZ, indicating an ameliorating effect of valsartan on these measures.
A versatile and scalable strategy for glycoprofiling bifidobacterial consumption of human milk oligosaccharides
Authors: LoCascio Riccardo G. , Niñonuevo Milady R. , Kronewitter Scott R. , Freeman Samara L. , German J. Bruce , Lebrilla Carlito B. , Mills David A.
Published: December 2008

Human milk contains approximately 200 complex oligosaccharides believed to stimulate the growth and establishment of a protective microbiota in the infant gut. The lack of scalable analytical techniques has hindered the measurement of bacterial metabolism of these and other complex prebiotic oligosaccharides. An in vitro, multi‐strain, assay capable of measuring kinetics of bacterial growth and detailed oligosaccharide consumption analysis by FTICR‐MS was developed and tested simultaneously on 12 bifidobacterial strains. For quantitative consumption, deuterated and reduced human milk oligosaccharide (HMO) standards were used. A custom software suite developed in house called Glycolyzer was used to process the large amounts of oligosaccharide mass spectra automatically with 13C corrections based on de‐isotoping protocols. High growth on HMOs was characteristic of Bifidobacterium longum biovar infantis strains, which consumed nearly all available substrates, while other bifidobacterial strains tested, B. longum bv. longum, B. adolescentis, B. breve and B. bifidum, showed low or only moderate growth ability. Total oligosaccharide consumption ranged from a high of 87% for B. infantis JCM 7009 to only 12% for B. adolescentis ATCC 15703. A detailed analysis of consumption glycoprofiles indicated strain‐specific capabilities towards differential metabolism of milk oligosaccharides. This method overcomes previous limitations in the quantitative, multi‐strain analysis of bacterial metabolism of HMOs and represents a novel approach towards understanding bacterial consumption of complex prebiotic oligosaccharides.
Ethiopian coffee cultivation—Implications for bird conservation and environmental certification
Authors: Gove Aaron D. , Hylander Kristoffer , Nemomisa Sileshi , Shimelis Anteneh
Published: December 2008

Coffee cultivation plays a role in biodiversity alteration and conservation in much of the tropics. This is particularly so in Ethiopia, where coffee is an indigenous shrub and a major commodity in national and local trade. In southwestern Ethiopia, coffee (Coffea arabica, “highland coffee”) is harvested from both forests (its natural habitat) and from within farmland where it is grown in small patches under isolated shade trees. We investigated the effects of management practices on bird assemblages in each of these systems. We found that bird assemblages in the forest remnants were distinct from those in the farmland even if many species were regularly found in both habitats. Coffee cultivation in open farmlands promoted bird species diversity through the retention of forest trees, while coffee cultivation in forests reduced bird diversity. Forest coffee management may, however, ensure that forest remnants are not converted to other forms of more open agriculture. Certification standards for “ecologically friendly” coffee in Ethiopia need to take this complexity into account.
Nascent RNA Sequencing Reveals Widespread Pausing and Divergent Initiation at Human Promoters
Authors: Core Leighton J. , Waterfall Joshua J. , Lis John T.
Published: December 2008

RNA polymerases are highly regulated molecular machines. We present a method (global run-on sequencing, GRO-seq) that maps the position, amount, and orientation of transcriptionally engaged RNA polymerases genome-wide. In this method, nuclear run-on RNA molecules are subjected to large-scale parallel sequencing and mapped to the genome. We show that peaks of promoter-proximal polymerase reside on ∼30% of human genes, transcription extends beyond pre-messenger RNA 3′ cleavage, and antisense transcription is prevalent. Additionally, most promoters have an engaged polymerase upstream and in an orientation opposite to the annotated gene. This divergent polymerase is associated with active genes but does not elongate effectively beyond the promoter. These results imply that the interplay between polymerases and regulators over broad promoter regions dictates the orientation and efficiency of productive transcription.
Compounds R1R2EMMe3 (E = P, As; M = Si, Sn) - Convenient and Versatile Reagents for the Syntheses of Tertiary (Fluoroaryl)phosphanes and -arsanes
Authors: Goryunov Leonid I. , Grobe Joseph , Shteingarts Vitalii D.
Published: December 2008

Synthetic and mechanistic aspects of nucleophilic replacement of fluorine in fluorobenzenes, fluoropyridines and fluoroquinolines by phosphanyl and arsanyl groups via their reactions with R1R2EMMe3 (E = P, As; M = Si, Sn; R1, R2 = Me, i-Pr, t-Bu, Ph, etc.) reagents are considered.
BARRIER HEIGHT ENHANCED GaN SCHOTTKY DIODES USING A THIN AlN SURFACE LAYER
Authors: CHUAH L. S. , HASSAN Z. , ABU HASSAN H. , YAM F. K. , CHIN C. W. , THAHAB S. M.
Published: December 2008

Gallium nitride (GaN) is a highly promising wide band gap semiconductor with applications in high power electronic and optoelectronic devices. Thin films of GaN are most commonly grown in the hexagonal wurtzite structure on sapphire substrates. Growth of GaN onto silicon substrates offers a very attractive opportunity to incorporate GaN devices onto silicon-based integrated circuits. Although direct epitaxial growth of GaN films on Si substrates is a difficult task (mainly due to the 17% lattice mismatch present), substantial progress in the crystal quality can be achieved using a buffer layer. A full characterization of the quality of the material needs to be assessed by a combination of different techniques.

In this work, a thin AlN cap layer of 50 nm was incorporated in GaN Schottky diode to enhance the effective Schottky barrier height and reduces the dark current. A barrier height of 0.52 eV for normal GaN Schottky diode was increased to the effective barrier height of 0.63 eV. The resulting Schottky diodes show a dark current of as low as 6.3×10-5 A at 5 V bias, which is about two orders of magnitude lower than that of normal GaN (5.2×10-3 A at 5 V bias) Schottky diode.
THE INSTABILITY OF INTERNAL POTENTIAL IN DOUBLE-BARRIER STRUCTURE
Authors: ZHOU XIAO-FANG , ZHAO XUE-AN , ZHENG JIN-LIANG
Published: December 2008

This work reports the internal potential distributions in double-barrier structure due to electron-electron interaction in mesoscopic ac transport. We focus on the properties of the internal potential in some special external voltages. It is found that the internal potential is stable in general situations, but it becomes auto-fluctuating and even random fluctuating in some special cases. In these special cases, the system becomes unstable.
COX-1 vs. COX-2 as a determinant of basal tone in the internal anal sphincter
Authors: de Godoy Márcio A. F. , Rattan Neeru , Rattan Satish
Published: December 2008

Prostanoids, produced endogenously via cyclooxygenases (COXs), have been implicated in the sustained contraction of different smooth muscles. The two major types of COXs are COX-1 and COX-2. The COX subtype involved in the basal state of the internal anal sphincter (IAS) smooth muscle tone is not known. To identify the COX subtype, we examined the effect of COX-1- and COX-2-selective inhibitors, SC-560 and rofecoxib, respectively, on basal tone in the rat IAS. We also determined the effect of selective deletion of COX-1 and COX-2 genes (COX-1−/−and COX-2−/−mice) on basal tone in murine IAS. Our data show that SC-560 causes significantly more efficacious and potent concentration-dependent decreases in IAS tone than rofecoxib. In support of these data, significantly higher levels of COX-1 than COX-2 mRNA were found in the IAS. In addition, higher levels of COX-1 mRNA and protein were expressed in rat IAS than rectal smooth muscle. In wild-type mice, IAS tone was decreased 41.4 ± 3.4% (mean ± SE) by SC-560 (1 × 10−5M) and 5.4 ± 2.2% by rofecoxib ( P < 0.05, n = 5). Basal tone was 0.172 ± 0.021 mN//mg in the IAS from wild-type mice and significantly less (0.080 ± 0.015 mN/mg) in the IAS from COX-1−/−mice ( P < 0.05, n = 5). However, basal tone in COX-2−/−mice was not significantly different from that in wild-type mice. We conclude that COX-1-related products contribute significantly to IAS tone.
Exercise-induced expression of VEGF and salvation of myocardium in the early stage of myocardial infarction
Authors: Wu Guifu , Rana Jamal S. , Wykrzykowska Joanna , Du Zhimin , Ke Qingen , Kang Peter , Li Jian , Laham Roger J.
Published: December 2008

The mechanism of exercise-induced benefit and angiogenesis in ischemic heart disease remains poorly defined. This study was designed to investigate the effects of exercise training on the expression of angiogenic factors and angiogenesis in the infarcted myocardium [myocarial infaction (MI)]. Sixty-three male FVB mice were used for study and were divided into subgroups to test the response to exercise: the time-dependent expression of angiogenic factors to exercise training in normal ( group 1; n = 12) and infarcted myocardium ( group 2; n = 15) and the exercise-induced angiogenic response in normal and infarcted myocardium ( group 3; n = 20) as well as the impact of exercise preconditioning on infarcted myocardium ( group 4; n = 26). Exercise training consisted of daily treadmill exercise for 1 h for 3 days. Expression of VEGF and its receptors Flt-1 and Flk-1 was upregulated by exercise training in mice with MI. Exercise-induced VEGF expression in the MI group was higher than that in the sham (control) group. Cell proliferation assessment showed a significantly higher ( P < 0.05) number of bromodeoxyuridine-positive cells in post-MI mice in the exercise group as opposed to post-MI mice in the sedentary group. 2,3,5-Triphenyltetrazolium chloride staining revealed a profound difference in the size of MI (18.25 ± 2.93%) in the exercise group versus the sedentary group (29.26 ± 7.64%, P = 0.02). Moreover, exercise preconditioning before MI promoted VEGF expression at both mRNA and protein levels. In conclusion, activation of VEGF and its receptors occurs in the infarcted mice heart in response to exercise, which results in decreased infarct size and improved angiogenesis.
Neuromuscular control in landing from supra-maximal dropping height
Authors: Galindo A. , Barthèlemy J. , Ishikawa M. , Chavet P. , Martin V. , Avela J. , Komi P. V. , Nicol C.
Published: December 2008

The present study utilized high-impact supra-maximal landings to examine the influence of the pre-impact force level on the post-impact electromyographic (EMG) activity and, in particular, on the short latency EMG reflex (SLR) component. Unilateral-leg landings were performed in a sitting position on a sledge apparatus after release from high, but individually constant dropping height. A lower limb guiding device fixed to the front of the sledge seat allowed the subjects to sustain a given pre-set force level up to impact. This force level was either freely chosen or set at 20, 35, and 50% of maximal isometric plantarflexion force. EMG activity was recorded from eight major lower limb muscles. It was expected that the increase in the pre-impact force level would require the intervention of a protective neural strategy during the post-impact phase that would attenuate the SLR amplitude. The ultrasonography recordings confirmed that the soleus fascicles were stretched to induce SLR. The main finding was the similarity across all tested conditions of the impact peak force and post-impact EMG activity, including the SLR response. Both observations are mostly attributed to the similar EMG levels and close force levels reached toward impact. The instruction to maintain a given pre-set force level was indeed overruled when getting close to impact. It is suggested that, in the present supra-maximal landing condition, a protective central neural strategy did occur that took into account the pre-set force level to secure similar impact loads.