Family, households, and care arrangements of frail older women: a structural analysis

Previous research has examined determinants of the living arrangements and the informal-care arrangements of older women; research on care arrangements has often taken living arrangements as given. Here we consider each separately, then go on to analyze the simultaneous determinants of living and care arrangements. Factors influencing these outcomes can be categorized as indicators of opportunities, resources, needs, or preferences. Of particular interest is the extent to which kin availability--specifically, the existence of living children--constrains opportunities, the role of financial resources, and the consequences of needs as revealed by levels of physical and mental disability. Our analysis consists of multinomial-logit models estimated with data from the 1982 National Long-Term Care Survey. The results indicate the importance of kin availability, with striking differences in the living and care arrangements between childless and other older women. Among those with children, there are less striking but consistent differences according to the number and sex composition of living children. Finally, variables representing needs for care are generally the strongest predictors of all the outcomes analyzed.     

The first case of locally acquired tick-borne Babesia microti infection in Canada

A child with a complicated medical history that included asplenia acquired an infection with Babesia microti in the summer of 2013 and had not travelled outside of Manitoba. Although the clinical findings were subtle, astute laboratory work helped to reach a preliminary identification of Babesia species, while reference laboratory testing confirmed the diagnosis. Blacklegged ticks (Ixodes scapularis) are known to transmit Borrelia burgdorferi and Anaplasma phagocytophilum in the province; however, the present case represents the first known instance of tick-borne B microti, both in Manitoba and in Canada. The expanding territory of the blacklegged tick increases the relevance of this emerging infection. Clinicians, laboratory medical practitioners and public health officials should be aware of B microti as a potential locally acquired infection in Canada.     

The influence of physicochemical properties on the reactivity and stability of acyl glucuronides†

1.?Formation of 1-O-acyl-β-d-glucuronide conjugates is a significant pathway in the metabolism of drugs containing a carboxylic acid group. The formation of acyl glucuronides results in an increase in both the aqueous solubility and molecular mass of the conjugate in comparison to the parent drug and thus facilitates excretion in both urine and bile.

2.?Acyl glucuronides are effectively esters, which undergo first order decomposition by both hydrolysis and the intra-migration of the acyl group around the glucuronide ring to yield 2-, 3- and 4-O-glucuronic acid esters which, unlike the metabolically formed 1-O-acyl-β-d-glucuronides, are not substrates for β-glucuronidase. The first order degradation half-life is therefore a composite value of these two reactions and a useful indicator of chemical reactivity and potential toxicity.

3.?Intra-molecular migration is expected to be the predominant pathway due to entropic considerations.

4.?Such conjugates, together with their isomeric ester derivatives, react with nucleophilic sites on proteins and small endogenous molecules, such as glutathione, which potentially contributes to the observed toxicity and adverse drug reactions associated with some drugs.

5.?Examination of the stability of the 1-O-acyl-β-d-glucuronides of aryl acetic acid, α-carbon substituted aryl acetic acid, aliphatic and aromatic acids, as determined by their first order degradation half-lives, indicates the significance of electronic and steric features that contribute to conjugate stability under physiological conditions.

6.?Examination of the of the electronic properties of the carbonyl carbon atom in acyl glucuronides, as measured by the pKa of the parent acid, together with the steric substituents about the acyl carbonyl provides insight into the reactivity of these conjugates.

7.?The investigations reported herein on a large number of 1-O-acyl-β-d-glucuronides has allowed rationalisation of their physicochemical properties in relation to the structure of the parent drug and has the potential to contribute to the design of carboxylic acid containing drug molecules with increased stability of a major metabolite with potential reduction in toxicity and adverse drug reactions.     

The Rheometric Analysis of the Polymer Modifier’s Properties in the Environment of Hydrated Cement

This paper investigates the effect of polymer modifiers (re-dispersible powder, multifunctional additives, methylhydroxyethylcellulose) on the rheological behavior of emulsions, saturated of calcium hydrosilicates to simulate a hydrating cement structure. The subjects of the study were modified emulsions which had varied concentrations of each additive and they were examined comparatively to a base emulsion. Tests were performed with a CR-rheometer (“Himpribor-1”, Tula, Russia) applying the Searle measuring principle at various shear rates to characterize viscosity properties. The performance of modified mixtures within the operating period was analyzed by using two parameters—effective viscosity (η) and the proportion of structural failure (|m|). The test results showed that the most important factor influencing rheological characteristics is the addition of methylhydroxyethylcellulose additive—the higher additive amount in the emulsion, the higher the viscosity. Furthermore it was noted in the work that adding olefin sulfonate sodium salt causes reduced viscosities as well as lower shear moduli. If ethylhydroxyethylcellulose and ethylene vinyl acetate additives are used in the same mixture together, the rate of structural failure |m| can be relatively similar and low regardless of whether the mixture has large or small viscosity values.     

Prevalence of cerebral palsy in Slovenia: birth years 1981 to 1990

Changes in the prevalence of cerebral palsy (CP) in a population of Slovenian children born between 1981 and 1990 were determined. A population-based birth-cohort study was undertaken. Seven hundred and sixty-eight children with CP (aged 5 to 14 years) were identified from the National Cerebral Palsy Register in 1995. Spastic syndromes accounted for 84.8%. Of the 768 children studied, the total prevalence of CP per 1000 live births fell significantly from 3.3 in 1981 to 2.3 in 1990. This decreasing trend was observed in children born at <38 weeks of gestation and in those with a birthweight of <1500 g, but the prevalence of CP remained fairly constant in those born at ≥38 weeks of gestation and in those with a birthweight of ≥2500g. The results show that a statistically significant improvement in the survival rate of infants born in Slovenia between 1981 and 1990 was not accompanied by an increase in the prevalence of CP. Additionally, in the group of very-low-birthweight infants the prevalence of CP considerably decreased.     

Tolerance of Oocystis nephrocytioides to copper: intracellular distribution and extracellular complexation of copper

Several mechanisms have been proposed to explain how algae can tolerate heavy metals. In order to better understand the mechanisms determining metal tolerance, we examined the interaction of copper with two strains of the copper-tolerant green algae Oocystis nephrocytioides, isolated from algal communities differing only in copper exposure. The strains were cultured in chemically-defined media containing 0.04 microM Cu(total) (pCu 12.4) or 2 microM Cu(total) (pCu 10.6). Growth, photosynthesis rate, content of chlorophyll a and b, copper accumulation, its cellular distribution and ultrastructural localization, as well as the influence of algal growth on extracellular copper complexation were determined. Both strains had comparable growth and photosynthesis rates. The cellular content of both chlorophyll a and b was reduced, by roughly the same extent, at pCu 10.6 compared to pCu 12.4. Copper titration of the media indicated the production of copper-complexing ligands by O. nephrocytioides cultured at pCu 12.4 that increased with increased algal density during cell growth. No additional ligands were detected at pCu 10.6. Copper-complexing ligands had a conditional stability constant of K = 10(13) at pH 7.3. The intracellular concentration of copper in O. nephrocytioides was 80 microM at pCu 12.4 and increased to 7.5mM at pCu 10.6. The proportion of intracellular Cu accumulated increased from 8% of total Cu content at pCu 12.4 to 60% at pCu 10.6. By electron spectroscopic imaging, intracellular Cu was detected in the thylakoids and the pyrenoid of O. nephrocytioides cells. The results indicate that the tolerance of O. nephrocytioides to Cu is constitutive and does not need to be induced by previous exposure to Cu. We propose that accumulation and sequestration of Cu in thylakoids and, to a lesser extent, adsorption of copper to the algal cell surface represent the most important tolerance mechanism, for O. nephrocytioides.     

The importance of non-invasive genetic analysis in the initial diagnostics of Alport syndrome in young patients

Alport syndrome is an important hereditary disorder characterized by nephritis and sometimes accompanied by impairment or loss of vision and hearing. The most common form of Alport syndrome is an X-linked dominant trait that has been associated with the gene COL4A5, one of the six types of IV collagen genes. More than 300 different mutations have been identified in the COL4A5 gene, and appear randomly along the whole gene. Three novel mutations, G198E, G3189D and G669R, were found in 5 young patients from 3 different Slovenian families. On the basis of the results of our study and the existing national register of Alport syndrome patients, we demonstrated that non-invasive methods, such as the genetic analysis of collagen genes, particularly in the case of young patients with undefined clinical features, may be of great importance and could diminish the need for invasive skin and renal biopsy. Our study showed the importance of molecular genetic data for the purpose of providing quick and precise diagnoses for affected family members and their offspring, particularly small children.M. lajpah and A. Megli contributed equally to this work