Developments in spin-polarized internal targets for storage rings have permitted measurements of 197 MeV polarized protons scattering from vector polarized deuterons. This work presents measurements ...of the polarization observables A(y), iT11, and C(y,y) in proton-deuteron elastic scattering. When compared to calculations with and without three-nucleon forces, the measurements provide further evidence that three-nucleon forces make a contribution to the observables. This work indicates that three-body forces derived from static nuclear properties appear to be crucial to the description of dynamical properties.
A pair of spin rotators has been installed in the electron ring of HERA. Longitudinal spin polarizations up to 65% have been reached reproducibly during dedicated measurement time. This is the first ...time that longitudinal spin polarization has been produced in a high energy electron storage ring.
We present a measurement of the longitudinal spin asymmetry A(||) in photoproduction of pairs of hadrons with high transverse momentum p(T). Data were accumulated by the HERMES experiment using a ...27.5 GeV polarized positron beam and a polarized hydrogen target internal to the HERA storage ring. For h(+)h(-) pairs with p(h(1))(T)>1.5 GeV/c and p(h(2))(T)>1.0 GeV/c, the measured asymmetry is A(||) = -0. 28+/-0.12(stat)+/-0.02(syst). This negative value is in contrast to the positive asymmetries typically measured in deep inelastic scattering from protons, and is interpreted to arise from a positive gluon polarization.
A laser driven source of polarized hydrogen and deuterium has been installed in the Cooler Ring at the Indiana University Cyclotron Facility. Polarized nuclei from the source are injected into a ...storage tube, and the resulting target has been used in a scattering experiment with 200 MeV proton beam. This paper discusses the performance of the source, including measurements of atomic fraction and electron polarization.
The HERMES Laser-Driven Target Task Force (Argonne, Erlangen, Illinois and Colorado) is charged with developing a polarized H/D target for use in the HERA ring at DESY. Rapid progress was made in the ...beginning of 1996, leading us to the decision to test the target in a realistic experimental environment. In particular, polarizations of 0.6 and flows above 10{sup 18} atoms{center_dot}s{sup -1} have been achieved on the bench. The laser-driven target and a simple detector system are currently installed in Cooler storage ring at the Indiana University Cyclotron Facility in order to test its applicability to nuclear physics experiments. Target polarizations are being measured using the H-vector(p,p) and D-vector(p,p) reactions. Initial tests were reasonably successful and the target is well along toward becoming viable for nuclear physics.
Malnutrition (MN) in nursing home (NH) residents is associated with poor outcome. In order to identify those with a high risk of incident MN, the knowledge of predictors is crucial. Therefore, we ...investigated predictors of incident MN in older NH-residents.
NH-residents participating in the nutritionDay-project (nD) between 2007 and 2018, aged ≥65 years, with complete data on nutritional status at nD and after 6 months and without MN at nD. The association of 17 variables (general characteristics (n = 3), function (n = 4), nutrition (n = 1), diseases (n = 5) and medication (n = 4)) with incident MN (weight loss ≥ 10% between nD and follow-up (FU) or BMI (kg/m
) < 20 at FU) was analyzed in univariate generalized estimated equation (GEE) models. Significant (p < 0.1) variables were selected for multivariate GEE-analyses. Effect estimates are presented as odds ratios and their respective 99.5%-confidence intervals.
Of 11,923 non-malnourished residents, 10.5% developed MN at FU. No intake at lunch (OR 2.79 1.56-4.98), a quarter (2.15 1.56-2.97) or half of the meal eaten (1.72 1.40-2.11) (vs. three-quarter to complete intake), the lowest BMI-quartile (20.0-23.0) (1.86 1.44-2.40) (vs. highest (≥29.1)), being between the ages of 85 and 94 years (1.46 1.05; 2.03) (vs. the youngest age-group 65-74 years)), severe cognitive impairment (1.38 1.04; 1.84) (vs. none) and being immobile (1.28 1.00-1.62) (vs. mobile) predicted incident MN in the final model.
10.5% of non-malnourished NH-residents develop MN within 6 months. Attention should be paid to high-risk groups, namely residents with poor meal intake, low BMI, severe cognitive impairment, immobility, and older age.
Malnutrition is widespread in older people and represents a major geriatric syndrome with multifactorial etiology and severe consequences for health outcomes and quality of life. The aim of the ...present paper is to describe current approaches and evidence regarding malnutrition treatment and to highlight relevant knowledge gaps that need to be addressed. Recently published guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) provide a summary of the available evidence and highlight the wide range of different measures that can be taken-from the identification and elimination of potential causes to enteral and parenteral nutrition-depending on the patient's abilities and needs. However, more than half of the recommendations therein are based on expert consensus because of a lack of evidence, and only three are concern patient-centred outcomes. Future research should further clarify the etiology of malnutrition and identify the most relevant causes in order to prevent malnutrition. Based on limited and partly conflicting evidence and the limitations of existing studies, it remains unclear which interventions are most effective in which patient groups, and if specific situations, diseases or etiologies of malnutrition require specific approaches. Patient-relevant outcomes such as functionality and quality of life need more attention, and research methodology should be harmonised to allow for the comparability of studies.
Frailty is common in nursing home (NH) residents, but its prevalence in German institutions is unknown. Valid and easy-to-use screening tools are needed to identify frail residents. We used the ...FRAIL-NH scale and the Clinical Frailty Scale (CFS) to (1) obtain the prevalence of frailty, (2) investigate the agreement between both instruments, and (3) evaluate their predictive validity for adverse health events in German NH residents.
Prospective cohort study.
German NH residents (n = 246, age 84 ± 8 years, 67% female).
Frailty status was categorized according to FRAIL-NH (nonfrail, frail, most frail) and CFS (not frail, mild to moderately frail, severely frail). Agreement between instruments was examined by Spearman correlation, an area under the receiver operating characteristic curve (AUC) with 95% CI, and sensitivity and specificity using the "most frail" category of FRAIL-NH as reference standard. Adverse health events (death, hospital admissions, falls) were recorded for 12 months, and multivariate cox and logistic regression models calculated.
According to FRAIL-NH, 71.1% were most frail, 26.4% frail, and 2.5% nonfrail. According to CFS, 66.3% were severely frail, 26.8% mild to moderately frail, and 6.9% not frail. Both scales correlated significantly (r = 0.78; R
= 60%). The AUC was 0.92 (95% CI 0.88-0.96). Using a CFS cutoff of 7 points, sensitivity was 0.90 and specificity 0.92. The frailest groups according to both instruments had an increased risk of death FRAIL-NH hazard ratio (HR) 2.19, 95% CI 1.21-3.99; CFS HR 2.56, 95% CI 1.43-4.58 and hospital admission FRAIL-NH odds ratio (OR) 1.95, 95% CI 1.06-3.58; CFS OR 1.79, 95% CI 1.01-3.20 compared to less frail residents. The FRAIL-NH predicted recurrent faller status (OR 2.57, 95% CI 1.23-5.39).
Frailty is highly prevalent in German NH residents. Both instruments show good agreement despite different approaches and are able to predict adverse health outcomes. Based on our findings and because of its simple administration, CFS may be an alternative to FRAIL-NH for assessing frailty in NHs.
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