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The growing population of older adults has attracted concern from policymakers due in part to the fact that they are at higher risk of costly and potentially injurious falls. Responding to this concern, this study investigated fall-related hospitalizations among those aged 65 and older. Hospitalizations rose from 49,299 to 58,931, with charges and costs (estimated based on charges) increasing from $2.5 billion to $3.6 billion and under $900 million to over $1.1 billion, respectively. The intraclass correlation coefficients from linear mixed-effect models (with charges and costs serving as dependent variables) indicated differences in hospitals accounted for nearly half or more of medical cost variation among older adults suffering a fall-related hospitalization. Nonmetropolitan residence, being aged 65-69 (versus older), and higher risk-of-mortality on admission indicated higher costs. Identifying trends of fall-related hospitalizations over time allows for key stakeholders to not only track the burden of falls among older adults but to also use this information to attract funding for fall prevention strategies from policy makers at various levels (e.g., locally, at the state). Further, identifying characteristics of individuals (e.g., age, race, sex) and places (e.g., rural areas) that carry a higher relative cost can serve to inform the targeted allocation of finite resources including local, state, or federal funding, but also existing evidence-based practices such as community and clinical interventions.Background Understanding the drivers of intimate partner violence (IPV), perpetrated by men and experienced by women, is a critical task for developing effective prevention programmes.Objectives To provide a comprehensive assessment of the drivers of IPV.Methods A comprehensive review of the drivers of IPV, at the end of a six-year programme of research through the What Works to Prevent Violence Against Women and Girls Global Programme with reference to other important research in the field.Results Broadly, we argue that IPV is driven by poverty, patriarchal privilege, and the normative use of violence in interpersonal relationships. These factors also increase childhood trauma, poor mental health and substance misuse, and poor communication and conflict in relationships, which in turn impact on IPV. Disability status, and contexts of armed conflict, or post-conflict, further reinforce and exacerbate these risks. We move beyond describing associations towards describing the causal pathways through which these factors operate to increase IPV.Conclusions Specific recommendations about the future of further research on drivers of IPV include a greater focus on understanding the causal pathways from drivers to IPV and clearly delineating association from causality in studies, particularly for women and girls with disabilities, in armed conflicts, and adolescent girls and young women. To achieve this, we recommend extensive in-depth qualitative research, and complex quantitative modeling studies. Understanding drivers and causal pathways better will enable the identification of points of entry for the development of more effective IPV prevention interventions.The current article presents the results of an exploratory research that examined 16 homicides perpetrated by grandchildren against their own grandmothers in Ghana, West Africa. The term grannicide was coined by the present author and employed in the current analysis to denote the slaying of a grandmother by her grandchildren. Data for the present study were extracted from various Ghanaian print and electronic media. Results from the analysis of data show that grannicide is gendered, with all 16 identified grannicides perpetrated by grandsons against grandmothers. Offenders typically were young and of low socioeconomic background. Victims were of advanced age, poor, and at least partially dependent on their children and grandchildren for economic, physical and social support. All the homicides occurred in the rural areas of the country, and the victims commonly shared a residence with the assailant. Witchcraft accusations were the predominant motive in grandchild-to-grandmother slayings. The killings were overwhelmingly brutal, exhibiting characteristics that criminologists call overkill. Recommendations for reducing this type of crime are offered.Pediatric patients receiving solid organ transplants may develop lymphoproliferative diseases, including graft-versus-host disease (GvHD) and posttransplant lymphoproliferative diseases (PTLDs). We characterized lesions in 11 clinically ill NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ (NSG) mice that received pediatric-patient-derived solid tumors (PDXs) and developed immunodeficiency-associated lymphoproliferations comparable to GvHD and PTLDs over a period of 46 to 283 days after implantation. NSC 640488 price Lymphoproliferations were diffusely positive for human-specific biomarkers, including NUMA1, CD45, and CD43, but lacked immunoreactivity for murine CD45. Human immune cells were CD3-positive, with subsets having immunoreactivity for CD4 and CD8 as well as PAX5, CD79a, and IRF4, resulting from populations of human T and B cells present within the xenotransplants. Tissues and organs infiltrated included mucocutaneous zones (oral cavity and perigenital and perianal regions), haired skin, tongue, esophagus, forestomach, thyroid, salivary glands, lungs, liver, kidneys, spleen, lymph nodes, bone marrow, and brain. In 4 of 5 mice with PTLD, Epstein-Barr virus (EBV)-encoded small RNAs (EBERs) were detected by in situ hybridization in PAX5+ human B cells associated with the PDX (n = 1/4) or with engrafted human immune cells at other anatomic locations (n = 4/11). link2 One of the 4 mice had an EBV-associated human large B-cell lymphoma. NSG mice receiving xenotransplants can develop combinations of GvHD, EBV-driven PTLD, and B-cell lymphoma similar to those occurring in human pediatric patients. Therefore, pediatric xenotransplants should undergo histopathologic and immunohistochemical assessment upon collection to ensure that the specimen is not a lymphoma and does not contain lymphoma cells because these neoplasms can morphologically mimic small round blue cell pediatric solid tumors.We describe caspofungin pharmacokinetics (PK) after the first and fourth doses in 20 critically ill septic patients. Monte Carlo simulation was used to analyze the probability of target attainment (PTA) (AUC/MIC > 865) for Candida spp. Caspofungin concentrations were analyzed by HPLC in plasma and urine. A great variability in PK parameters was observed after both doses. Patients were divided in two groups according to their AUC values (AUC ≤ 75 mg h/L cut-off). In the low-AUC group Cmax, Cmin and AUC were lower, while Vd and Cl were higher than in the high-AUC group (p less then 0.05, both at day 1 and 4). The mean 24-h urinary recovery of the drug was 8 ± 6.3% (day1) and 9.8 ± 6.3 (day4). Monte Carlo simulation analysis (0.03-1 mg/L MIC-range) showed that PTA was guaranteed only for MICs ≤ 0.03 mg/L in the low-AUC group, and for MICs ≤ 0.06 mg/L in the high-AUC group. No group had a PTA ≥ 90% for 0.125 mg/L MIC (the epidemiological cut-off). Mortality was higher in low-AUC group (p less then 0.01). In our 'real-world' population, no clinical data can predict which patient will have lower, suboptimal caspofungin exposure, therefore we suggest TDM to optimize caspofungin therapy and reduce the risk of selecting resistances (CEAVC, 32366/2015; OSS.15.114, NCT03798600).Purpose Rates of organic farms and women organic farmers are increasing. Yet, this recent surge brings new and uncertain challenges for injury epidemiology. Since many in the population are of child-bearing age, and child agricultural injury is a significant threat, of particular relevance are the knowledge, attitudes, and beliefs towards risk of child injury.Methods A paper, self-administered 11-question questionnaire was distributed at four events geared towards early career women organic farmers. The questionnaire generated data around select demographics, attitudes towards farm safety, and sources of safety knowledge.Findings & Discussion The questionnaire had a 45% response rate. As expected, most respondents were new to farming (1-3 years' experience as a primary owner/operator), and 47% reported having a child under the age of 18 years work on the farm. While respondents recognized farms were generally unsafe for children, they reported their own farm as safe for children. Preferred sources of safety knowledge were those with user-generated content from other farmers.Conclusion Interventions with new women organic farmers in the Midwest are likely to be most effective by incorporating social media, networking with area farmers' groups, and addressing the optimism bias. Information not explicitly marketed as safety information may gain traction. A more complete analysis of risk, incidence, and prevalence of this niche population is important.The purpose of this study was (1) accurately estimate longitudinal relationships between decimal age (i.e., chronological and relative) and performance in Australian female 100 m (N = 765) and 200 m (N = 428) Breaststroke swimmers (10-18 years); and (2) determine whether corrective adjustment procedures could remove Relative Age Effects (RAEs) in an independent sample of age-matched 100 m (N = 2,491) and 200 m (N = 1,698) state/national level Breaststroke swimmers. In Part 1, growth curve modelling quantified longitudinal relationships between decimal age and swimming performance. In Part 2, relative age distributions (Quartile 1-4) for "All", "Top 25%" and "10%" of swimming times were examined based on raw and correctively adjusted swim times for age-groups. Based on raw swim times, finding identified RAE effect sizes increased in magnitude (small-medium) with selection level ("All"-"Top 25%") in 12-14 years age-groups for both events. However, when correctively adjusted swim performances were examined, RAEs were primarily absent across all age-groups and selection levels. link3 Using longitudinal reference data, corrective adjustment procedures removed relative age advantages in female youth Breaststroke performance. Removing the influence of relative age-related differences is predicted to improve the accuracy of identifying genuinely skilled youth swimmers.Children come to prefer fair distributions at the age of 5 to 6 years. But do they actually want to be fair, or do they want to appear fair to others? In three conditions, an experimenter initially distributed chocolates to 5-/6-year-old participants and partners they were paired with. Participants always possessed, through some means, two chocolates when the experimenter returned after a brief absence, and they had to decide whether to take an extra one for themselves. To measure the extent to which children were concerned with actually being fair versus appearing fair, two conditions were created in which children were led to believe that the experimenter did not know that the distributions had become equal. In the windfall condition, a confederate gave one additional chocolate to the participant, and in the partner condition, the partner transferred one chocolate to the participant. Compared to the control condition, participants who passed the false belief task in both of these conditions tried to appear fair in their distribution.
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