Search Results (24)

Background: Complications due to frailty and injury after falls are a significant problem for people living in residential aged care. This can lead to a range of negative outcomes including poor physical, social, and psychological well-being. The Australian Royal Commission into Aged Care Quality and Safety highlighted many aspects of care in residential aged care homes requiring improvement, leading to specific recommendations aimed at improving the outcomes in this area. This contributed to four recommendations calling for increased allied health interventions to meet the unmet needs in residential aged care. This intervention aims to implement and evaluate evidence-based allied health interventions for people living in residential aged care specifically relating to frailty, preventing falls, and maintaining engagement in everyday activities. Method: This is a pragmatic, non-randomised, pre–post design study where six groups of up to 10 residents of an aged care home will start the intervention at staggered times. The EAHOP intervention is an integrated application of a suite of allied health services (occupational therapy, physiotherapy, dietetics, speech pathology, pharmacy, and optometry), with general practitioner involvement, using allied health assistants in an integrated transdisciplinary model of care. The baseline period is 6 weeks, and intervention is a maximum of 36 weeks with follow-up at 12 and 24 weeks. Primary outcomes measure changes in falls, frailty, and quality of life. A qualitative program evaluation will be completed as well as an economic analysis. Conclusion: The results of the study will provide information about the clinical, implementation, and effectiveness outcomes of this integrated, transdisciplinary allied health service model for people living in residential aged care. The results will be used to develop evidence-informed guidelines for residential aged care providers on the delivery of allied health services. Full article

Background: With an estimated global prevalence rate of over 30%, dental fear is a ubiquitous public health phenomenon. Dental fear’s adverse effects on patient oral health and quality of life are well established; the stresses and financial repercussions it can pose to providers are increasingly recognized. Although dental fear is highly treatable, a disseminable intervention that satisfies the needs of patients and dental care providers has yet to be realized. Objectives: We sought to understand allied dental professionals’ experiences treating patients with dental fear and their impressions of, and receptivity to, a stepped-care approach, including perceived barriers and facilitators to its adoption. Methods: Thirteen semi-structured focus groups comprising students in (a) current dental hygiene programs and (b) other dental programs, who had prior experience working as licensed dental hygienists or allied professionals (i.e., dental assistants, dental therapists, dental treatment coordinators; N = 49) were conducted. Focus group discussions were recorded, transcribed, and thematically analyzed. Results: Participant responses supported the need for innovation in managing dental fear in practices, and supported hygienists as likely facilitators of any new behavioral approach. Overall, participants were receptive to the idea of a stepped-care treatment approach but identified several factors (e.g., accessibility, costs, treatment credibility) that would need to be addressed for its adoption by patients and dental professionals. Conclusion: A stepped-care approach to dental fear treatment has promise to meet the needs of patients and dental professionals. Potential barriers and facilitators to adoption provide a roadmap for future intervention refinement and efficacy testing. Full article

The Imaging X-ray Polarimetry Explorer (IXPE) has confirmed that X-ray polarimetry is a valuable tool in astronomy, providing critical insights into the emission processes and the geometry of compact objects. IXPE was designed to be sensitive in the 2–8 keV energy range for three primary reasons: (1) celestial X-ray sources are bright within this range, (2) the optics are effective, and (3) most sources across various classes were expected to exhibit some level of polarization. Indeed, IXPE is a great success, and its discoveries are necessitating the revision of many theoretical models for numerous sources. However, one of IXPE’s main limitations is its relatively narrow energy band, coupled with rapidly declining efficiency. In this paper, we will demonstrate the benefits of devising a mission focused on a broader energy band (0.1–79 keV). This approach leverages current technologies that align well with theoretical expectations and builds on the successes of IXPE. Full article

Replacing alkaline for alkaline-earth metal hydroxide in the synthesis gel during the synthesis of siliceous SSZ-13 zeolite (Si/Al~10) yields SSZ-13 with novel, advantageous properties. Its NH₄-form ion-exchanges higher amount of isolated divalent M(II) ions than the conventional one: this is the consequence of an increased number of Al pairs in the structure induced by the +2 charge of Sr(II) cations in the synthesis gel that force two charge-compensating AlO₄⁻ motives to reside closer together. We characterize the +2 state of Co(II) ions in these materials with infra-red spectroscopy and X-ray absorption spectroscopy measurements and show their utility for NOx pollutant adsorption from ambient air: the ones derived from SSZ-13 with higher Al pair content contain more isolated cobalt(II) and, thus, perform better as ambient-air NOx adsorbers. Notably, Co(II)/SSZ-13 with an increased number of Al pairs is significantly more hydrothermally stable than its NaOH-derived analogue. Loading Pd(II) into Co-SSZ-13(Sr) produces an active NOx adsorber (PNA) material that can be used for NOx adsorption from simulated diesel engine exhaust. The critical issue for these applications is hydrothermal stability of Pd-zeolites. Pd/SSZ-13 synthesized in the presence of Sr(OH)₂ does not lose its PNA capacity after extremely harsh aging at 850 and 900 °C (10 h in 10% H₂O/air flow) and loses only ~55% capacity after hydrothermal aging at 930 °C. This can be extended to other divalent metals for catalytic applications, such as copper: we show that Cu/SSZ-13 catalyst can survive hydrothermal aging at 920 °C without losing its catalytic properties, metal dispersion and crystalline structure. Thus, we provide a new, simple, and scalable strategy for making remarkably (hydro)thermally stable metal-zeolite materials/catalysts with a number of useful applications. Full article

Cancer is a disease associated with ageing. Managing cancer in older adults may prove challenging owing to pre-existing frailty, comorbidity, and wider holistic needs, as well as the unclear benefits and harms of standard treatment options. With the ongoing advances in oncology and the increasing complexity of treating older adults with cancer, the geriatric oncology field must be a priority for healthcare systems in education, research, and clinical practice. However, geriatric oncology is currently not formally taught in undergraduate education or postgraduate training programmes in the United Kingdom (UK). In this commentary, we outline the landscape of geriatric oncology undergraduate education and postgraduate training for UK doctors. We highlight current challenges and opportunities and provide practical recommendations for better preparing the medical workforce to meet the needs of the growing population of older adults with cancer. This includes key outcomes to be considered for inclusion within undergraduate and postgraduate curricula. Full article

Research suggests parental ability to recognise when their child has overweight is limited. It is hypothesised that recognition of child overweight/obesity is fundamental to its prevention, acting as a potential barrier to parental action to improve their child’s health-related behaviours and/or help seeking. The purpose of this study was to investigate the efficacy of an intervention (MapMe) to improve parental ability to correctly categorise their child as having overweight one-month post-intervention, and reduce child body mass index (BMI) z-score 12 months post-intervention. MapMe consists of body image scales of known child BMI and information on the consequences of childhood overweight, associated health-related behaviours and sources of support. We conducted a three-arm (paper-based MapMe, web-based MapMe and control) randomised control trial in fifteen English local authority areas with parents/guardians of 4–5- and 10–11-year-old children. Parental categorisation of child weight status was assessed using the question ‘How would you describe your child’s weight at the moment?’ Response options were: underweight, healthy weight, overweight, and very overweight. Child weight status and BMI z-scores were calculated using objectively measured height and weight data and UK90 clinical thresholds. There was no difference in the percentage of parents correctly categorising their child as having overweight/very overweight (n = 264: 41% control, 48% web-based, and 43% paper-based, p = 0.646). BMI z-scores were significantly reduced for the intervention group at 12 months post-intervention compared to controls (n = 338, mean difference in BMI z-score change −0.11 (95% CI −0.202 to −0.020, p = 0.017). MapMe was associated with a decrease in BMI z-score 12 months post-intervention, although there was no direct evidence of improved parental ability to correctly categorise child overweight status. Further work is needed to replicate these findings in a larger sample of children, investigate mechanisms of action, and determine the use of MapMe as a public health initiative. Full article

Point mutations in the β2 (N265S) and β3 (N265M) subunits of γ-amino butyric acid type A receptors (GABA_ARs) that render them insensitive to the general anesthetics etomidate and propofol have been used to link modulation of β2-GABA_ARs to sedation and β3-GABA_ARs to surgical immobility. These mutations also alter GABA sensitivity, and mice carrying the β3-N265M mutation have been reported to have impaired baseline memory. Here, we tested the effects of the β2-N265M and β3-N265M mutations on memory, movement, hotplate sensitivity, anxiety, etomidate-induced sedation, and intrinsic kinetics. We found that both β2-N265M and β3-N265M mice exhibited baseline deficits in the Context Preexposure Facilitation Effect learning paradigm. Exploratory activity was slightly greater in β2-N265M mice, but there were no changes in either genotype in anxiety or hotplate sensitivity. β2-N265M mice were highly resistant to etomidate-induced sedation, and heterozygous mice were partially resistant. In rapid solution exchange experiments, both mutations accelerated deactivation two- to three-fold compared to wild type receptors and prevented modulation by etomidate. This degree of change in the receptor deactivation rate is comparable to that produced by an amnestic dose of etomidate but in the opposite direction, indicating that intrinsic characteristics of GABA_ARs are optimally tuned under baseline conditions to support mnemonic function. Full article

Treatment regimens for head and neck squamous cell carcinoma (HNSCC) typically include cisplatin and radiotherapy and are limited by toxicities. We have identified naturally derived withalongolide A triacetate (WGA-TA) from Physalis longifolia as a lead compound for targeting HNSCC. We hypothesized that combining WGA-TA with cisplatin may allow for lower, less toxic cisplatin doses. HNSCC cell lines were treated with WGA-TA and cisplatin. After treatment with the drugs, the cell viability was determined by MTS assay. The combination index was calculated using CompuSyn. The expression of proteins involved in the targeting of translational initiation complex, epithelial to mesenchymal transition (EMT), and apoptosis were measured by western blot. Invasion and migration were measured using the Boyden-chamber assay. Treatment of MDA-1986 and UMSCC-22B cell lines with either WGA-TA or cisplatin alone for 72 h resulted in a dose dependent decrease in cell viability. Cisplatin in combination with WGA-TA resulted in significant synergistic cell death starting from 1.25 μM cisplatin. Combination treatment with WGA-TA resulted in lower cisplatin dosing while maintaining the downregulation of translational initiation complex proteins, the induction of apoptosis, and the blockade of migration, invasion, and EMT transition. These results suggest that combining a low concentration of cisplatin with WGA-TA may provide a safer, more effective therapeutic option for HNSCC that warrants translational validation. Full article

Measurement of the adverse outcomes of repeated head trauma in athletes is often achieved using tests where the comparator is ‘accuracy’. While it is expected that ex-athletes would perform worse than controls, previous studies have shown inconsistent results. Here we have attempted to address these inconsistencies from a different perspective by quantifying not only accuracy, but also motor response times. Age-matched control subjects who have never experienced head trauma (n = 20; 41.8 ± 14.4 years) where compared to two cohorts of retired contact sport athletes with a history of head trauma/concussions; one with self-reported concerns (n = 36; 45.4 ± 12.6 years), and another with no ongoing concerns (n = 19; 43.1 ± 13.5 years). Participants performed cognitive (Cogstate) and somatosensory (Cortical Metrics) testing with accuracy and motor times recorded. Transcranial magnetic stimulation (TMS) investigated corticospinal conduction and excitability. Results showed that there was little difference between groups in accuracy scores. Conversely, motor times in all but one test revealed that ex-athletes with self-reported concerns were significantly slower compared to other groups (p ranges 0.031 to <0.001). TMS latency showed significantly increased time (p = 0.008) in the group with ongoing concerns. These findings suggest that incorporating motor times is more informative than considering accuracy scores alone. Full article

Whilst several studies have explored adolescent metabolic and cognitive function after preterm birth, few have explored muscle function and physical activity. We set out to examine the relationship between gestational age and muscle metabolism in a cohort of adolescents who were born preterm. Participants were recruited from the Newcastle preterm birth growth study cohort. They did not have severe neurological disease and were not on daily medication. Participants underwent an assessment of oxidative muscle function using phosphorus magnetic resonance spectroscopy that included the half-time for recovery of equilibrium of phosphocreatine, τ_½PCr. In addition, we measured key variables that might affect muscle function including physical activity levels determined by 3-day accelerometry, body composition using air displacement plethysmography, insulin sensitivity using the homeostatic model assessment/Matsuda index and serum vitamin D concentrations. 60 adolescents (35F) median age 15.6 years (range 12.1–18.8) with a median gestation of 31 weeks (range 24 to 34 weeks) underwent a single assessment. Males were more active and spent less time in sedentary mode. Time spent in light activity was associated with insulin sensitivity (IS) (Matsuda Index; p < 0.05) but there were no strong correlations between activity levels and gestational age. Greater fat mass, waist circumference and body mass index were all associated with lower IS. Gestational age was negatively associated with adjusted measures of oxidative muscle function (τ_½PCr). In a stepwise multivariate linear regression model, gestational age at birth was the most significant predictor of oxidative muscle function (p = 0.005). Higher serum vitamin D levels were also associated with faster phosphocreatine recovery time (p = 0.045). Oxidative function in the skeletal muscle of adolescents born preterm is associated with gestational age and vitamin D concentrations. Our study suggests that being born preterm may have a long-term impact on muscle metabolism. Full article

Quinoa is being evaluated in cropping systems in many countries outside of its natural range of South America. Very few attempts have been made by farmers or researchers to grow or evaluate quinoa under Australian environments. Given the growing popularity of quinoa with consumers, new commercial opportunities for farmers and international interest in the crop, it was timely to undertake a comprehensive evaluation of the potential of quinoa in Australia. Two advanced selections and nine germplasm lines (six of Chilean and three of Bolivian origin) identified in an earlier project were tested in 23 field trials at 14 locations on mainland Australia. Targets included irrigated sites in tropical, Mediterranean, semi-arid and desert climates, and rain-fed sites of south-western Australia with a Mediterranean climate. The field experiments were either a randomised complete block design (RBCD) or a split plot/factorial design with 2–4 replicates, and a linear mixed model was used to compare the treatment lines. Seed yield of quinoa was highest when grown in winter and spring under rain-fed conditions in Geraldton, in spring and summer under irrigation at Bool Lagoon, and summer, autumn and winter under irrigation at Leeton. The highest seed yield achieved was 3 t/ha for a germplasm line from Chile, while the highest yield for a germplasm line from Bolivia was 2.6 t/ha. Advanced selections from Australia yielded well in comparison at most trial sites. Declining seed yield was associated with mean daily temperatures during seed development increasing above 17 °C, mean daily temperatures during flowering declining below 15 °C, and rainfall during seed development under rain-fed conditions falling below 50 mm. Seed produced at Bool Lagoon was the closest in colour to white quinoa imported from Peru; however, it was more than noticeably different. Seed produced at Geraldton and Leeton was significantly larger than from other field sites; however, none were larger than 2 mm in diameter as found in Royal white quinoa from Bolivia. Superior seed colour and seed size were associated with dry conditions at maturity and cool conditions during seed development, respectively. We conclude that quinoa can become a potential crop option for Australian agriculture by exploiting genetic diversity and supplementing with suitable management practices matched to agro-climatic environments. There are reasonable prospects to raise the seed yield potential in areas in all states, especially in the regions where quinoa grew well in our experiments. Full article

A new generation magnetic spectrometer in space will open the opportunity to investigate the frontiers in direct high-energy cosmic ray measurements and to precisely measure the amount of the rare antimatter component in cosmic rays beyond the reach of current missions. We propose the concept for an Antimatter Large Acceptance Detector In Orbit (ALADInO), designed to take over the legacy of direct measurements of cosmic rays in space performed by PAMELA and AMS-02. ALADInO features technological solutions conceived to overcome the current limitations of magnetic spectrometers in space with a layout that provides an acceptance larger than 10 m${}^2$ sr. A superconducting magnet coupled to precision tracking and time-of-flight systems can provide the required matter–antimatter separation capabilities and rigidity measurement resolution with a Maximum Detectable Rigidity better than 20 TV. The inner 3D-imaging deep calorimeter, designed to maximize the isotropic acceptance of particles, allows for the measurement of cosmic rays up to PeV energies with accurate energy resolution to precisely measure features in the cosmic ray spectra. The operations of ALADInO in the Sun–Earth L2 Lagrangian point for at least 5 years would enable unique revolutionary observations with groundbreaking discovery potentials in the field of astroparticle physics by precision measurements of electrons, positrons, and antiprotons up to 10 TeV and of nuclear cosmic rays up to PeV energies, and by the possible unambiguous detection and measurement of low-energy antideuteron and antihelium components in cosmic rays. Full article

In a previous study based on this cohort, only 15% of the participants belonged to a favourable physical activity/sedentary behaviour trajectory group (characterised by relatively high moderate–vigorous intensity physical activity and relatively low sedentary behaviour across childhood and adolescence). Since this favourable trajectory is protective against obesity, we aimed to identify factors associated with membership of this group. In this longitudinal study, 671 participants were assessed at ages 7, 9, 12 and 15 years. Participants’ demographics, socio-economic status (SES) and physical activity environment such as, sports club participation and commuting school were assessed at ages 7, 9 and 12 and analysed with favourable trajectory membership as an outcome using multinomial logistic regression. Sex (male) and SES (higher) were the non-modifiable factors associated with favourable trajectory group. Of the modifiable factors, commuting to school at age 7, a safe environment to play at age 7 and sports club participation at age 12 were all associated with more than 2.0 times increased probability of being in the most favourable trajectory. Future interventions to promote a favourable trajectory could focus on girls and participants with low SES. Promoting active commuting, safe local spaces to play and sports participation should also help lead to a favourable trajectory for physical activity and sedentary behaviour across childhood and adolescence. Full article

This paper provides a longitudinal examination of local inequalities in health behaviours during a period of austerity, exploring the role of ‘place’ in explaining these inequalities. Data from the Stockton-on-Tees prospective cohort study of 836 individuals were analysed and followed over 18 months (37% follow-up). Generalised estimating equation models estimated the deprivation gap in health behaviours (smoking status, alcohol use, fruit and vegetable consumption and physical activity practices) between the 20% most- and least-deprived neighborhoods (LSOAs), explored any temporal changes during austerity, and examined the underpinning role of compositional and contextual determinants. All health behaviours, except for frequent physical activity, varied significantly by deprivation (p ≤ 0.001). Smoking was lower in the least-deprived areas (OR 0.21, CI 0.14 to 0.30), while alcohol use (OR 2.75, CI 1.98 to 3.82) and fruit and vegetable consumption (OR 2.55, CI 1.80 to 3.62) were higher in the least-deprived areas. The inequalities were relatively stable throughout the study period. Material factors (such as employment, education and housing tenure) were the most-important and environmental factors the least-important explanatory factors. This study suggests that material factors are the most important ‘place’ determinants of health behaviours. Health promotion activities should better reflect these drivers. Full article

The combined role of objectively assessed moderate-vigorous intensity physical activity (MVPA) and sedentary behaviour (SB) is unclear in obesity prevention. This study aimed to identify latent groups for MVPA and SB trajectories from childhood to adolescence and examine their relationship with obesity risk at adolescence. From the Gateshead Millennium Study, accelerometer-based trajectories of time spent in MVPA and SB at ages 7, 9, 12, and 15 were derived as assigned as the predictor variable. Fat mass index (FMI), using bioelectrical impedance at age 15, was the outcome variable. From 672 children recruited, we identified three distinct multiple trajectory groups for time spent in MVPA and SB. The group with majority membership (54% of the cohort) had high MVPA and low SB at childhood, but MVPA declined and SB increased by age 15. One third of the cohort (31%) belonged to the trajectory with low MVPA and high time spent sedentary throughout. The third trajectory group (15% of the cohort) that had relatively high MVPA and relatively low SB throughout had lower FMI (−1.7, 95% CI (−3.4 to −1.0) kg/m², p = 0.034) at age 15 compared to the inactive throughout group. High MVPA and low SB trajectories when combined are protective against obesity. Full article