Abstract
Background
self-reported data regarding health conditions are utilised in both clinical practice and research, but their agreement with general practice records is variable. The extent of ...this variability is poorly studied amongst older adults, particularly amongst those with multiple health conditions, cognitive impairment or frailty. This study investigates the agreement between self-reported and general practice-recorded data amongst such patients and the impact of participant factors on this agreement.
Methods
data on health conditions was collected from participants in the Community Ageing Research 75+ (CARE75+) study (n = 964) by self-report during face-to-face assessment and interrogation of the participants’ general practice electronic health records. Agreement between self-report and practice records was assessed using Kappa statistics and the effect of participant demographics using logistic regression.
Results
agreement ranged from K = 0.25 to 1.00. The presence of ≥2 health conditions modified agreement for cancer (odds ratio, OR:0.62, 95%confidence interval, CI:0.42–0.94), diabetes (OR:0.55, 95%CI:0.38–0.80), dementia (OR:2.82, 95%CI:1.31–6.13) and visual impairment (OR:3.85, 95%CI:1.71–8.62). Frailty reduced agreement for cerebrovascular disease (OR:0.45, 95%CI:0.23–0.89), heart failure (OR:0.40, 95%CI:0.19–0.84) and rheumatoid arthritis (OR:0.41, 95%CI:0.23–0.75). Cognitive impairment reduced agreement for dementia (OR:0.36, 95%CI:0.21–0.62), diabetes (OR:0.47, 95%CI:0.33–0.67), heart failure (OR:0.53, 95%CI:0.35–0.80), visual impairment (OR:0.42, 95%CI:0.25–0.69) and rheumatoid arthritis (OR:0.53, 95%CI:0.37–0.76).
Conclusions
significant variability exists for agreement between self-reported and general practice-recorded comorbidities. This is further affected by an individual’s health conditions. This study is the first to assess frailty as a factor modifying agreement and highlights the importance of utilising the general practice records as the gold standard for data collection from older adults.
We obtained spectra in the wavelength range lambda = 995-1769 nm of all four known planets orbiting the star HR 8799. Using the suite of instrumentation known as Project 1640 on the Palomar 5 m Hale ...Telescope, we acquired data at two epochs. This allowed for multiple imaging detections of the companions and multiple extractions of low-resolution (R ~ 35) spectra. Data reduction employed two different methods of speckle suppression and spectrum extraction, both yielding results that agree. The spectra do not directly correspond to those of any known objects, although similarities with L and T dwarfs are present, as well as some characteristics similar to planets such as Saturn. We tentatively identify the presence of CH sub(4) along with NH sub(3) and/or C sub(2)H sub(2), and possibly CO sub(2) or HCN in varying amounts in each component of the system. Other studies suggested red colors for these faint companions, and our data confirm those observations. Cloudy models, based on previous photometric observations, may provide the best explanation for the new data presented here. Notable in our data is that these presumably co-eval objects of similar luminosity have significantly different spectra; the diversity of planets may be greater than previously thought. The techniques and methods employed in this paper represent a new capability to observe and rapidly characterize exoplanetary systems in a routine manner over a broad range of planet masses and separations. These are the first simultaneous spectroscopic observations of multiple planets in a planetary system other than our own.
The human oral cavity contains a diversity of microbial habitats that have been adopted and adapted to as homeland by an amazingly heterogeneous population of microorganisms collectively referred to ...as the oral microbiota. These microbes generally co-habit in harmonious homeostasis. However, under conditions of imposed stress, as with changes to the host's physiology or nutritional status, or as a response to foreign microbial or antimicrobial incursions, some components of the oral "microbiome" (viz. the
microbiota) may enter a dysbiotic state. This microbiome dysbiosis can manifest in a variety of guises including streptococcal sore throats, dental caries, oral thrush, halitosis and periodontal disease. Most of the strategies currently available for the management or treatment of microbial diseases of the oral cavity focus on the repetitive "broad sweep" and short-term culling of oral microbe populations, hopefully including the perceived principal pathogens. Both physical and chemical techniques are used. However, the application of more focused approaches to the harnessing or elimination of key oral cavity pathogens is now feasible through the use of probiotic strains that are naturally adapted for oral cavity colonization and also are equipped to produce anti-competitor molecules such as the bacteriocins and bacteriocin-like inhibitory substances (viz BLIS). Some of these probiotics are capable of suppressing the proliferation of a variety of recognized microbial pathogens of the human mouth, thereby assisting with the restoration of oral microbiome homeostasis. BLIS K12 and BLIS M18, the progenitors of the BLIS-producing oral probiotics, are members of the human oral cavity commensal species
More recently however, a number of other streptococcal and some non-streptococcal candidate oral probiotics have also been promoted. What is becoming increasingly apparent is that the future for oral probiotic applications will probably extend well beyond the attempted limitation of the direct pathological consequences of oral microbiome dysbiosis to also encompass a plethora of systemic diseases and disorders of the human host. The background to and the evolving prospects for the beneficial modulation of the oral microbiome
the application of BLIS-producing
probiotics comprises the principal focus of the present review.
The skin is the largest organ in the human body, and it orchestrates many functions that are fundamentally important for our survival. Although the skin might appear to present a relatively ...inhospitable or even hostile environment, a multitude of commensals and also some potentially pathogenic microorganisms have successfully adapted to survive and/or thrive within the diverse ecological niches created by the skin’s topographical architecture. Dysbiosis within these microbial populations can result in the emergence and pathological progression of skin diseases. Unsurprisingly, this has led to a new focus of research both for the medical dermatology and cosmetic industries that is concerned with modulation of the skin microbiome to help address common microbially mediated or modulated conditions such as acne, body odour, and atopic dermatitis. This review presents an overview of our current understanding of the complex relationship of the skin with its microbiome and then introduces the concept of probiotic intervention for the management of microbial dysbiosis within the skin ecosystem.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Adolescence has long been considered a period of increased risk behaviour. This supposition has been supported by a wealth of empirical evidence and recently, health risk behaviours have been ...identified as a key mechanism for the general deterioration of adolescent health relative to other age groups. Research regarding adolescent risk behaviour suggests that there are often strong links between individual risk behaviours. The mechanisms for these associations have been attributed to common risk and protective factors, as well as gateway effects stemming from increased accessibility to additional risk behaviours. This has important implications for policy interventions designed to reduce risk behaviours in adolescence. Not only does a multiple risk behaviour approach increase the effectiveness of individual risk behaviour policy, but it is also conducive to a more cohesive, coherent and efficient approach to adolescent risk in general. Several examples of cohesive policy responses to multiple risk behaviours have emerged, but generally, policy remains segregated into individual risk domains. With increasing evidence for the effectiveness of integrated approaches, multiple risk behaviours require consideration to design and implement effective and efficient policy responses.
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BFBNIB, NMLJ, NUK, OILJ, PNG, UL, UM, UPUK, VSZLJ
Bacteriocin-producing probiotic Streptococcus salivarius M18 offers beneficial modulatory capabilities within the oral microbiome, apparently through potent inhibitory activity against potentially ...deleterious bacteria, such as Streptococcus pyogenes. The oral cavity persistence of S. salivarius M18 was investigated in 75 subjects receiving four different doses for 28 days. Sixty per cent of the subjects already had some inhibitor-producing S. salivarius in their saliva prior to probiotic intervention. Strain M18's persistence was dependent upon the dose, but not the period of administration. Culture analysis indicated that in some individuals the introduced strain had almost entirely replaced the indigenous S. salivarius, though the total numbers of the species did not increase. Selected subjects showing either high or low probiotic persistence had their salivary populations profiled using Illumina sequencing of the V6 region of the 16S rRNA gene. Analysis indicated that while certain bacterial phenotypes were markedly modulated, the overall composition of the oral microbiome was not modified by the probiotic treatment. Megaplasmids encoding bacteriocins and adhesion factors were transferred in vitro to generate a transconjugant S. salivarius exhibiting enhanced antimicrobial production and binding capabilities to HEp-2 cells. Since no widespread perturbation of the existing indigenous microbiota was associated with oral instillation and given its antimicrobial activity against potentially pathogenic streptococci, it appears that application of probiotic strain M18 offers potential low impact alternative to classical antibiotic prophylaxis. For candidate probiotic strains having relatively poor antimicrobial or adhesive properties, unique derivatives displaying improved probiotic performance may be engineered in vitro by megaplasmid transfer.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Long-term care facilities (LTCFs) are a potentially important reservoir of multidrug-resistant (MDR) organisms; however, limited data exist.
A point-prevalence study was conducted in four co-located ...LTCFs in Australia. Nasal and rectal swabs were cultured for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and MDR Gram-negative bacilli (GNB). Molecular typing and resistance detection were performed. Risk factors for colonization with an MDR organism were determined using a nested case-control study.
Consent was obtained from 115 (85%) of 136 eligible participants. Forty-one (36%) residents carried at least one type of MDR organism. The prevalence was 16% MRSA (n = 18), 6% VRE (n = 7) and 21% MDR GNB n = 24; including extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (n = 12) and Acinetobacter baumannii (n = 6). The majority of ESBL-producing E. coli and A. baumannii were clonal. Current wound management adjusted OR (AOR) 8.81 (95% CI 2.78-27.94), P < 0.001, medical device in situ AOR 5.58 (95% CI 1.34-23.32), P = 0.018 and pressure ulcer AOR 3.69 (95% CI 1.06-12.86), P = 0.04 were independent risk factors for MDR organism colonization. Advanced dementia AOR 3.54 (95% CI 1.23-10.23), P = 0.02 and prolonged antibiotic use AOR 2.95 (95% CI 1.01-8.60), P = 0.047 were independently associated with MRSA colonization, whilst current wound management AOR 15.59 (95% CI 4.85-50.10), P < 0.001 and fluoroquinolone use AOR 4.27 (95% CI 1.20-15.25), P = 0.025 were risk factors for MDR GNB colonization.
LTCFs are an important reservoir of MDR organisms, with person-to-person transmissions being a potential issue. We have identified several predictors of colonization with MDR organisms, allowing a more targeted management of high-risk residents.
The National Aeronautics and Space Administration (NASA) initiated a program called Operation IceBridge for monitoring critical parts of Greenland and Antarctica with airborne LIDARs until ICESat-II ...is launched in 2016. We have been operating radar instrumentation on the NASA DC-8 and P-3 aircraft used for LIDAR measurements over Antarctica and Greenland, respectively. The radar package on both aircraft includes a radar depth sounder/imager operating at the center frequency of 195 MHz. During high-altitude missions flown to perform surface-elevation measurements, we also collected radar depth sounder data. We obtained good ice thickness information and mapped internal layers for both thicker and thinner ice. We successfully sounded 3.2-km-thick low-loss ice with a smooth surface and also sounded about 1-km or less thick shallow ice with a moderately rough surface. The successful sounding required processing of data with an algorithm to obtain 56-dB or lower range sidelobes and array processing with a minimum variance distortionless response algorithm to reduce cross-track surface clutter. In this paper, we provide a brief description of the radar system, discuss range-sidelobe reduction and array processing algorithms, and provide sample results to demonstrate the successful sounding of the ice bottom interface from high altitudes over the Antarctic and Greenland ice sheets.
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