Self-reported quality of care for older adults from 2004 to 2011: a cohort study

Background: little is known about changes in the quality of medical care for older adults over time. Objective: to assess changes in technical quality of care over 6 years, and associations with participants' characteristics. Design: a national cohort survey covering RAND Corporation-derived quality indicators (QIs) in face-to-face structured interviews in participants' households. Participants: a total of 5,114 people aged 50 or more in four waves of the English Longitudinal Study of Ageing. Methods: the percentage achievement of 24 QIs in 10 general medical and geriatric clinical conditions was calculated for each time point, and associations with participants' characteristics were estimated using logistic regression. Results: participants were eligible for 21,220 QIs. QI achievement for geriatric conditions (cataract, falls, osteoarthritis and osteoporosis) was 41% [95% confidence interval (CI): 38–44] in 2004–05 and 38% (36–39) in 2010–11. Achievement for general medical conditions (depression, diabetes mellitus, hypertension, ischaemic heart disease, pain and cerebrovascular disease) improved from 75% (73–77) in 2004–05 to 80% (79–82) in 2010–11. Achievement ranged from 89% for cerebrovascular disease to 34% for osteoarthritis. Overall achievement was lower for participants who were men, wealthier, infrequent alcohol drinkers, not obese and living alone. Conclusion: substantial system-level shortfalls in quality of care for geriatric conditions persisted over 6 years, with relatively small and inconsistent variations in quality by participants' characteristics. The relative lack of variation by participants' characteristics suggests that quality improvement interventions may be more effective when directed at healthcare delivery systems rather than individuals

Alien Registration- Richards, Luke (Orono, Penobscot County)

https://digitalmaine.com/alien_docs/5946/thumbnail.jp

Model Analysis of the ep→ep′π+π−ep \to ep'\pi^+\pi^- Electroproduction Reaction on the Proton

Recent CLAS data on the $p\pi^+\pi^-$ electroproduction off protons at 1.3$<$W$<$1.57 GeV and 0.25$<$$Q^{2}$$<$0.6 GeV$^{2}$ have been analyzed using a meson-baryon phenomenological model. By fitting nine 1-fold differential cross section data for each $W$ and $Q^{2}$ bin, the charged double pion electroproduction mechanisms are identified from their manifestations in the observables. We have extracted the cross sections from amplitudes of each of the considered isobar channels as well as from their coherent sum. We also obtained non-resonant partial wave amplitudes of all contributing isobar channels which could be useful for advancing a complete coupled-channel analysis of all meson electroproduction data.Comment: Experiment Numbers: E93-006, E94-005 Group: Hall

Formation in Christ through conflict : discerning God\u27s gifts in group spiritual direction

https://place.asburyseminary.edu/ecommonsatsdissertations/2632/thumbnail.jp

Lattice Study of the Decay B^0-bar -> rho^+ l^- nu_l-bar: Model-Independent Determination of |V_{ub}|

We present results of a lattice computation of the vector and axial-vector current matrix elements relevant for the semileptonic decay B^0-bar -> rho^+ l^- nu_l-bar. The computations are performed in the quenched approximation of lattice QCD on a 24^3 x 48 lattice at beta = 6.2, using an O(a) improved fermionic action. Our principal result is for the differential decay rate, dGamma/dq^2, for the decay B^0-bar -> rho^+ l^- nu_l-bar in a region beyond the charm threshold, allowing a model-independent extraction of |V_{ub}| from experimental measurements. Heavy quark symmetry relations between radiative and semileptonic decays of B-bar mesons into light vector mesons are also discussed.Comment: 22 pages LaTeX-209 (dependent on settings in a4.sty), 23 PostScript figures included with epsf.sty. Complete PostScript file including figures available at http://wwwhep.phys.soton.ac.uk/hepwww/papers/shep9518

Ecological Predictors of Organelle Genome Evolution: Phylogenetic Correlations with Taxonomically Broad, Sparse, Unsystematized Data

Comparative analysis of variables across phylogenetically linked observations can reveal mechanisms and insights in evolutionary biology. As the taxonomic breadth of the sample of interest increases, challenges of data sparsity, poor phylogenetic resolution, and complicated evolutionary dynamics emerge. Here, we investigate a cross-eukaryotic question where all these problems exist: which organismal ecology features are correlated with gene retention in mitochondrial and chloroplast DNA (organelle DNA or oDNA). Through a wide palette of synthetic control studies, we first characterize the specificity and sensitivity of a collection of parametric and non-parametric phylogenetic comparative approaches to identify relationships in the face of such sparse and awkward datasets. This analysis is not directly focused on oDNA, and so provides generalizable insights into comparative approaches with challenging data. We then combine and curate ecological data coupled to oDNA genome information across eukaryotes, including a new semi-automated approach for gathering data on organismal traits from less systematized open-access resources including encyclopedia articles on species and taxa. The curation process also involved resolving several issues with existing datasets, including enforcing the clade-specificity of several ecological features and fixing incorrect annotations. Combining this unique dataset with our benchmarked comparative approaches, we confirm support for several known links between organismal ecology and organelle gene retention, identify several previously unidentified relationships constituting possible ecological contributors to oDNA genome evolution, and provide support for a recently hypothesized link between environmental demand and oDNA retention. We, with caution, discuss the implications of these findings for organelle evolution and of this pipeline for broad comparative analyses in other fields.publishedVersio

Ischemic preconditioning in the liver is independent of regulatory T cell activity

Ischemic preconditioning (IPC) protects organs from ischemia reperfusion injury (IRI) through unknown mechanisms. Effector T cell populations have been implicated in the pathogenesis of IRI, and T regulatory cells (Treg) have become a putative therapeutic target, with suggested involvement in IPC. We explored the role of Treg in hepatic IRI and IPC in detail. IPC significantly reduced injury following ischemia reperfusion insults. Treg were mobilized rapidly to the circulation and liver after IRI, but IPC did not further increase Treg numbers, nor was it associated with modulation of circulating pro-inflammatory chemokine or cytokine profiles. We used two techniques to deplete Treg from mice prior to IRI. Neither Treg depleted FoxP3.LuciDTR mice, nor wildtyoe mice depleted of Tregs with PC61, were more susceptible to IRI compared with controls. Despite successful enrichment of Treg in the liver, by adoptive transfer of both iTreg and nTreg or by in vivo expansion of Treg with IL-2/anti-IL-2 complexes, no protection against IRI was observed.We have explored the role of Treg in IRI and IPC using a variety of techniques to deplete and enrich them within both the liver and systemically. This work represents an important negative finding that Treg are not implicated in IPC and are unlikely to have translational potential in hepatic IRI

Measuring Equality in Machine Learning Security Defenses

The machine learning security community has developed myriad defenses for evasion attacks over the past decade. An understudied question in that community is: for whom do these defenses defend? In this work, we consider some common approaches to defending learned systems and whether those approaches may offer unexpected performance inequities when used by different sub-populations. We outline simple parity metrics and a framework for analysis that can begin to answer this question through empirical results of the fairness implications of machine learning security methods. Many methods have been proposed that can cause direct harm, which we describe as biased vulnerability and biased rejection. Our framework and metric can be applied to robustly trained models, preprocessing-based methods, and rejection methods to capture behavior over security budgets. We identify a realistic dataset with a reasonable computational cost suitable for measuring the equality of defenses. Through a case study in speech command recognition, we show how such defenses do not offer equal protection for social subgroups and how to perform such analyses for robustness training, and we present a comparison of fairness between two rejection-based defenses: randomized smoothing and neural rejection. We offer further analysis of factors that correlate to equitable defenses to stimulate the future investigation of how to assist in building such defenses. To the best of our knowledge, this is the first work that examines the fairness disparity in the accuracy-robustness trade-off in speech data and addresses fairness evaluation for rejection-based defenses.Comment: In Submissio

Effect of Food Intake on RER Values During Submaximal Treadmill Exercise

The purpose of this experiment was to observe the extent to which food consumption prior to exercise affects fuel oxidation during submaximal exercise.It was hypothesized that individuals in the fasted state will utilize fat oxidation as the primary fuel source longer than individuals fed prior to exercise. This will be reflected by lower RER values throughout the graded exercise protocol.https://digitalcommons.gardner-webb.edu/exercise-science-research-proposal-posters/1074/thumbnail.jp