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Introduction With population ageing the prevalence of multi-morbidity (the co-occurrence of two or more chronic medical conditions) is increasing. Objectives and Approach Our goal was to use data linkage to obtain clinically validated data on the incidence of a range of common chronic conditions developed by participants in the Australian Longitudinal Study on Women’s Health (57,000 women) and hence to track the cumulative incidence of multi-morbidity over time. Results The major data sources differed for different conditions, e.g. the Pharmaceutical Benefits Scheme was important for identifying musculoskeletal conditions, whereas hospital admission data was crucial for identifying stroke. The most common combinations of conditions differed for women at different ages, e.g., mental health, musculoskeletal and respiratory conditions were most common for women born in 1989-95, whereas heart disease was a prominent part of multi-morbidity for women born in 1921-26. Among these older women about 50% had 3 or more chronic conditions in 2002 (when they were aged 76-81) and this increased to over 80% by 2015 (when they were 89-93). For comparison, among women born in 1973-78 fewer than 5% had 2 or more chronic conditions in 2002 (when they were aged 24-29) and this increased to about 15% in 2016 (when they were 38-43). Conclusion / Implications Record linkage from multiple data sources, repeated over a long time span, is a powerful method for studying the development of multi-morbidity patterns in cohorts.

Introduction Persistent hypercapnic failure in chronic obstructive pulmonary disease (COPD) is associated with poor prognosis. Long-term home non-invasive ventilation is recommended for patients with PaCO2 >7.0 kPa. Domiciliary high-flow nasal cannula (HFNC) reduces PaCO2 in short-term studies. This post-hoc analysis examines the effect of HFNC on PaCO2 levels, exacerbations and admissions in patients with COPD with persistent hypercapnic and hypoxic failures.Methods The original trial included 74 long-term oxygen-treated patients (31 HFNC treated/43 controls) with persistent hypercapnic failure (PaCO2 >6 kPa) who completed the 12-month study period. Baseline data included age, sex, blood gases, exacerbations and hospital admissions in the previous year. Data on blood gases were also recorded at 6 and 12 months for all patients. In addition, acute changes in blood gases after 30 min of HFNC use at site visits were examined, as were exacerbations and hospital admissions during study.Results Patients were comparable at baseline. After 12 months there was a 1.3% decrease in PaCO2 in patients using HFNC and a 7% increase in controls before HFNC use on site (p=0.003). After 30 min of HFNC at visits PaCO2 changed significantly, with comparable reductions, at 0, 6 and 12 months, including for controls who tried HFNC at study end (p

Line Hust Storgaard,1 Hans-Ulrich Hockey,2 Birgitte Schantz Laursen,3,4 Ulla Møller Weinreich1,3 1Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; 2Biometrics Matters Limited, Hamilton, New Zealand; 3Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 4Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark Background: This study investigated the long-term effects of humidified high-flow nasal cannula (HFNC) in COPD patients with chronic hypoxemic respiratory failure treated with long-term oxygen therapy (LTOT).Patients and methods: A total of 200 patients were randomized into usual care ± HFNC. At inclusion, acute exacerbation of COPD (AECOPD) and hospital admissions 1 year before inclusion, modified Medical Research Council (mMRC) score, St George’s Respiratory Questionnaire (SGRQ), forced expiratory volume in 1 second (FEV1), 6-minute walk test (6MWT) and arterial carbon dioxide (PaCO2) were recorded. Patients completed phone interviews at 1, 3 and 9 months assessing mMRC score and AECOPD since the last contact. At on-site visits (6 and 12 months), mMRC, number of AECOPD since last contact and SGRQ were registered and FEV1, FEV1%, PaCO2 and, at 12 months, 6MWT were reassessed. Hospital admissions during the study period were obtained from hospital records. Hours of the use of HFNC were retrieved from the high-flow device.Results: The average daily use of HFNC was 6 hours/day. The HFNC group had a lower AECOPD rate (3.12 versus 4.95/patient/year, p

Parent-child interaction therapy (PCIT) is widely used by speech and language therapists to improve the interactions between children with delayed language development and their parents/carers. Despite favourable reports of the therapy from clinicians, little evidence of its effectiveness is available. We investigated the effects of PCIT as practised by clinicians within a clinical setting. Eighteen consecutive children referred for speech and language therapy because of their delayed language were entered in the study. A within-participants design was used, and the procedure was similar to that used clinically. Blind assessments were conducted twice before therapy to monitor change without therapy and once after completing PCIT. Significant changes in a parent rating scale, the children's mean length of utterance and the ratio of time of child to parent speech were found after the therapy. No changes were detected prior to therapy. The similarity of the design to clinical practice and the use of several clinicians suggest that the findings can be generalized to other settings and clinicians. These findings are a first step in evaluating PCIT; we now need to show that parents can maintain their newly acquired skills in interaction, and that this benefits their children's communication.

Membrane contact sites are regions of close apposition between organelles that facilitate information transfer. Here, we reveal an essential role for Ca2+ derived from the endo-lysosomal system in maintaining contact between endosomes and the endoplasmic reticulum (ER). Antagonizing action of the Ca2+-mobilizing messenger NAADP, inhibiting its target endo-lysosomal ion channel, TPC1, and buffering local Ca2+ fluxes all clustered and enlarged late endosomes/lysosomes. We show that TPC1 localizes to ER-endosome contact sites and is required for their formation. Reducing NAADP-dependent contacts delayed EGF receptor de-phosphorylation consistent with close apposition of endocytosed receptors with the ER-localized phosphatase PTP1B. In accord, downstream MAP kinase activation and mobilization of ER Ca2+ stores by EGF were exaggerated upon NAADP blockade. Membrane contact sites between endosomes and the ER thus emerge as Ca2+-dependent hubs for signaling.

The relationship between better diet quality and decreased depression across the life span is consistent and compelling. Fruit and vegetable consumption has been of particular interest. The nutritional benefits from the consumption of fruits and vegetables may mitigate non-communicable diseases and promote brain and mental health. This study aimed to determine whether fruit and vegetable consumption during adolescence was associated with a reduced risk of developing depression in adulthood in a large, representative sample of US individuals. Data from the Add Health Study were analyzed, which included 3,696 participants who were aged approximately 17 years at baseline (1994–1995), and 29 years at follow-up (2007–2008). The Center for Epidemiologic Studies Depression Scale was used to assess depression and a self-report item asked how many times the participant consumed fruit/vegetables on the previous day. Individuals who were depressed at both times points had the highest proportion who failed to consume any fruit (31%) or vegetables (42%) on the previous day. Fruit and vegetable consumption did not predict of adult depression in fully adjusted models. Cross sectional associations existed for diet and adolescent depression only. Our initial findings supported fruit and vegetable consumption as being protective against adult depression, but this association was subsequently attenuated on adjustment for other relevant factors. Future research will benefit from more precise measures of dietary intakes.

With the exception of lecturing staff, research on occupational groups and cultures within the UK higher education system is relatively sparse. This paper focuses upon one specialist group, to-date under-researched but which plays a central role in contemporary higher education administration: graduate research administrators. This occupational group is of particular interest as its members administer and manage an increasing complex and key area of university life, which in many cases appears to span the putative occupational divide between "academic" and "administrative" work. Based upon qualitative interviews with 27 research administrators, and using some of Bourdieu's conceptual devices, the paper analyses particular kinds of informal occupational knowledge and practice, necessary in order effectively to "do" the complex task of research administration in the pressurized environment of contemporary British higher education.

One of the challenges of the Biotechnology industry is keeping up to date with the rapid pace of change and that much of the information, which students learn in their undergraduate studies, will be out of date in a few years. It is therefore crucial that Biotechnology students have the skills to access the relevant information for their studies and critically evaluate the vast volume of information and its sources. By developing information literacy skills, which are part of lifelong learning, Biotechnology graduates are better prepared for their careers. Students also need to understand the issues related to the use of information such as social, political, ethical, and legal implications. This paper will outline the embedding of information literacy skills within the Biotechnology degree at the University of South Australia. Examples of specific activities and their link to assessment will be discussed. (Contains 2 tables and 1 figure.)

Art and design practice-based PhDs have been developing in the United Kingdom for the past 15 years, yet there has been almost no research on how these degrees are experienced by students and their supervisors. This article sets out to remedy this lacuna by portraying some of the problems encountered by students in working toward such degrees and some of the solutions they arrive at with the aid of their supervisors. The article is based on extensive qualitative interviewing of both groups.

Two experiments tested the hypothesis that task-induced mental fatigue is moderated by control over work scheduling. Participants worked for 2 hr on simulated office work, with control manipulated by a yoking procedure. Matched participants were assigned to conditions of either high control (HC) or low control (LC). HC participants decided their own task scheduling, whereas LC participants had to follow these fixed schedules. For Experiment 1, fatigue was higher in LC participants who worked harder, so Experiment 2 compared control effects in high- and low-workload groups. As predicted, the impact of workload was reduced under HC conditions, for subjective fatigue, and most secondary tasks and aftereffects. The findings are interpreted within the framework of compensatory control theory.

Contract researchers constitute a marginal occupational group within the UK higher education system, and they manifest a high degree of turnover, in terms of leaving employment and returning to it. This article, which is based on qualitative interviews, examines some of the informal work which social science contract researchers engage in as they attempt to return to employment within academia. First, by examining the vocabularies of motive held by researchers, the article depicts why individuals should make efforts to return to such a marginal occupation. Second, the article then depicts the various kinds of informal work which researchers engage in so as to raise their employment chances. These different kinds of work are portrayed at an interactional level and at the level of individual identity.

To determine whether the visuospatial n-back working memory task is a reliable and valid measure of cognitive processes believed to underlie intelligence, this study compared the reaction times and accuracy of performance of 70 participants, with performance on the Multidimensional Aptitude Battery (MAB). Testing was conducted over two sessions separated by 1 week. Participants completed the MAB during the second test session. Moderate test-retest reliability for percentage accuracy scores was found across the four levels of the n-back task, whilst reaction times were highly reliable. Furthermore, participants' performance on the MAB was negatively correlated with accuracy of performance at the easier levels of the n-back task and positively correlated with accuracy of performance at the harder task levels. These findings confirm previous research examining the cognitive basis of intelligence, and suggest that intelligence is the product of faster speed of information processing, as well as superior working memory capacity.

The written autobiographical accounts of three life-course offenders, which were published following extended life-course offending, were analyzed using a theory-led thematic analysis. The protagonists were each responsible for a broad range of acquisitive and violent crimes, although different offense types are often studied as separate entities. The utility of narrative theory was explored as a life-course theory by contrasting its framework with these disparate areas of inquiry, along the developmental trajectory of the protagonist’s account. Findings showed that onset began with trait-driven and versatile offending, which progressed toward specialization, incorporating modus operandi and rational choice making. Specialization was underpinned by themes of violence and control. The concluding themes dealt with the process of desistance, which was facilitated by a series of cognitive shifts, allowing these offenders to retain a core element of the “self.” Results further showed that narrative-identity played an influential role in the development of specialization and eventual desistance, but less so with onset. Narrative theory has the potential to aid understanding of the criminal life-course trajectory, which in turn can assist in both detection and rehabilitation processes.

Burglary continues to yield low detection rates, and although the characteristics of how burglaries are committed has been investigated in some detail, less is known about how burglars avoid detection generally and in particular the activities of non-apprehended burglars. To investigate this issue, one can at least in principle investigate the special case of burglars who claim to have avoided apprehension in spite of the fact that they have committed a large number of burglaries over time. The approach taken here was to thematically analyze the interview data from a previous study comparing the crime scene movements of a small group of non-apprehended burglars with experienced but apprehended burglars. The results here from a thematic analysis of that previous study revealed marked differences in the rationales between the experienced, apprehended burglars and the experienced non-apprehended burglars when implementing different crime scene behaviors. A series of techniques and strategies emerges, which appear to aid in avoiding detection around the burglary scene and are summarized with implications discussed.

Describes novel ways in which the Orlando Project, based at the Universities of Alberta and Guelph, is using Standardized General Markup Language (SGML) to create an integrated electronic history of British women's writing in English. Discusses the types of documents being created and the related SGML requirements. (DSK)

Background: Grasslands are heavily utilised for livestock agriculture and the resultant degradation through mismanagement contributes to an estimated 60% of this biome being permanently transformed. This study focused on the impact of fire and grazing in moist highland grasslands. Objectives: To determine the contribution of burning frequency and grazing intensity combined (for domestic livestock and indigenous ungulates) on vegetation structure heterogeneity and species diversity. Methods: Eight study sites under different management regimes were sampled over two summers. Vegetation structure characteristics and diversity data were collected monthly within multiple replicates in each study site. A disc pasture meter was used to assess standing biomass. Differences in vegetation structure characteristics, plant community composition and plant species assemblage structure across sites were statistically analysed using analyses of variance, indicator species analyses, multidimensional scaling ordinations and two-way cluster analyses. Results: The combination of heavy grazing and annual burning leads to a distinct plant community dominated by disturbance specialist species. Selective grazing by indigenous herbivores promotes a community of unpalatable species. This study illustrates that fenced indigenous herbivores, even at moderate stocking densities, have a greater detrimental impact on plant diversity and structure than do domestic livestock. Conclusion: Intensive grazing and burning have a detrimental impact on plant species diversity and structure. This also affects resultant palatability for grazing livestock and fenced game. To promote both grazing quality and ecological integrity we recommend a minimum sustainable ‘fodder capacity’ or standing phytomass of 5000 kg per large-animal unit per hectare for domestic livestock in moist highland grasslands.

Utilizes an interpretive social psychology framework (examining the role played by language and the social contexts through which people account for their conduct) to explore the stated motives of PhD supervisors. Identifies three categories of motives--intellectual, functional, and subjective (self-esteem)--and discusses the use of language within each one. (MJP)

Researches the relationship between the PhD student and supervisor. Examines two strategies used by supervisors in supervising social science students: a loosely structured approach and a tightly controlled one. Finds that effective supervision depends one a balanced involvement with students, and the possession of certain qualities such as flexibility and sensitivity. (DSK)

A discussion of the structure of the social sciences doctorate in the United Kingdom looks at the debate over whether the doctoral degree process should be viewed as education or training, the situation in other countries, graduate student learning and development processes, collegiality, the graduate student-advisor relationship, and student selection. (Author/MSE)

BackgroundFaced with the challenge of recruiting young adults for health studies, researchers have increasingly turned to the Internet and social networking sites, such as Facebook, as part of their recruitment strategy. As yet, few large-scale studies are available that report on the characteristics and representativeness of the sample obtained from such recruitment methods. ObjectiveThe intent of the study was to describe the sociodemographic and health characteristics of a national sample of young Australian women recruited mainly through the Internet and social networking sites and to discuss the representativeness of their sociodemographic, health, and lifestyle characteristics relative to the population. MethodsA cohort of 17,069 women (born between 1989 and 1995) was recruited in 2012-13 for the Australian Longitudinal Study on Women’s Health. Sociodemographic characteristics (percentages, means, and 95% confidence intervals) from the online survey data were compared with women aged 18-23 years from the 2011 Australian Census. Sample data were compared by age and education level with data from the 2011-13 Australian Health Survey (AHS). ResultsCompared to the Australian Census data, study participants were broadly representative in terms of geographical distribution across Australia, marital status (95.62%, 16,321/17,069) were never married), and age distribution. A higher percentage had attained university (22.52%, 3844/17,069) and trade/certificate/diploma qualifications (25.94%, 4428/17,069) compared with this age group of women in the national population (9.4% and 21.7% respectively). Among study participants, 22.05% (3721/16,877) were not in paid employment with 35.18% (5931/16,857) studying 16 or more hours a week. A higher percentage of study participants rated their health in the online survey as fair or poor (rather than good, very good, or excellent) compared with those participating in face-to-face interviews in the AHS (18.77%, 3203/17,069 vs 10.1%). A higher percentage of study participants were current smokers (21.78%, 3718/17,069 vs 16.4%) and physically active (59.30%, 10,089/17,014 were classified as sufficiently active vs 48.3%) but alcohol consumption was lower (59.58%, 9865/16,558 reported drinking alcohol at least once per month vs 65.9% in the AHS). Using self-reported height and weight to determine body mass index (BMI, kg/m2), 34.80% (5901/16,956) of the cohort were classified as overweight or obese (BMI of 25 or more), compared with 33.6% respectively using measured height and weight in the AHS. ConclusionsFindings indicated that using the Internet and social networking sites for an online survey represent a feasible recruitment strategy for a national cohort of young women and result in a broadly representative sample of the Australian population.

Statement of problem: Surface staining of resin composite by dietary factors may be modified by the placement of a low-viscosity surface sealant aimed at reducing surface voids and defects occurring after light-curing and polishing. Objectives: The aim of this study was to investigate the staining effect of various drinks and temperatures on the surface sealant (Fortify Plus™) sealed on a nano-filled resin composite (Supreme XTE™) after artificial aging at different temperatures. Materials and Methods: Surface sealant was applied on one surface of forty resin composite discs (10×2 mm). Five discs each were immersed in test solutions of black cola, commercial dark grape juice, coffee and distilled water (negative control). Discs were either placed at 4°C (20 discs) or 37°C (20 discs) and the colour difference (ΔE) was calculated based on the colour coordinates at 0 (baseline), 7, 14 and 28 days of staining treatment. Two-factor with replication analysis was carried out with ANOVA. Results: The results showed significant discolouration after 28 days immersion in coffee (P

Host and pathogen ecology are often closely linked, with evolutionary processes often leading to the development of host specificity traits in some pathogens. Host specificity may range from 'generalist', where pathogens infect any available competent host; to 'specialist', where pathogens repeatedly infect specific host species or families. Avian malaria ecology in the region remains largely unexplored, despite the presence of vulnerable endemic avian species. We analysed the expression of host specificity in avian haemosporidia, by applying a previously developed host specificity index to lineages isolated from wetland passerines in the Western Cape, South Africa. Parasite lineages were isolated using PCR and identified when possible using matching lineages deposited in GenBank and in MalAvi. Parasitic clades were constructed from phylogenetic trees consisting of Plasmodium and Haemoproteus lineages. Isolated lineages matched some strains of Plasmodium relictum, P. elongatum, Haemoproteus sylvae and H. lanii. Plasmodium lineages infected a wide range of hosts from several avian families in a generalist pattern of infection. Plasmodium spp. also exhibited an infection trend according to host abundance rather than host species. By contrast, Haemoproteus lineages were typically restricted to one or two host species or families, and displayed higher host fidelity than Plasmodium spp. The findings confirm that a range of host specificity traits are exhibited by avian haemosporidia in the region. The traits show the potential to not only impact infection prevalence within specific host species, but also to affect patterns of infection at the community level.

Apolipoprotein (apo)A-IV is synthesized in the small intestine during fat absorption and is incorporated onto the surface of nascent chylomicrons. In circulation, apoA-IV is displaced from the chylomicron surface by high density lipoprotein-associated C and E apolipoproteins; this exchange is critical for activation of lipoprotein lipase and chylomicron remnant clearance. The variant allele A-IV-2 encodes a Q360H polymorphism that increases the lipid affinity of the apoA-IV-2 isoprotein. We hypothesized that this would impede the transfer of C and E apolipoproteins to chylomicrons, and thereby delay the clearance of postprandial triglyceride-rich lipoproteins. We therefore measured triglycerides in plasma, Sf > 400 chylomicrons, and very low density lipoproteins (VLDL) in 14 subjects heterozygous for the A-IV-2 allele (1/2) and 14 subjects homozygous for the common allele (1/1) who were fed a standard meal containing 50 gm fat per m2 body surface area. All subjects had the apoE-3/3 genotype. Postprandial triglyceride concentrations in the 1/2 subjects were significantly higher between 2–5 h in plasma, chylomicrons, and VLDL, and peaked at 3 h versus 2 h for the 1/1 subjects. The area under the triglyceride time curves was greater in the 1/2 subjects (plasma, P = 0.045; chylomicrons, P = 0.027; VLDL, P = 0.063). A posthoc analysis of the frequency of the apoA-IV T347S polymorphism suggested that it had an effect on triglyceride clearance antagonistic to that of the A-IV-2 allele. We conclude that individuals heterozygous for the A-IV-2 allele display delayed postprandial clearance of triglyceride-rich lipoproteins. —Hockey, K. J., R. A. Anderson, V. R. Cook, R. R. Hantgan, and R. B. Weinberg. Effect of the apolipoprotein A-IV Q360H polymorphism on postprandial plasma triglyceride clearance.