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This study highlights primary caregivers’ experiences with health department policies designed to support people with cognitive impairment/Alzheimer’s Disease and Related Dementias (ADRD). Caregivers were defined as individuals aged 45-85 that provide at least 10 hours of unpaid care. Five, 90-minute focus groups were conducted virtually with 24 caregivers of individuals with cognitive impairment/ADRD. Transcripts were analyzed thematically. Caregivers were primarily Black females (75%) with at least a high school education (42%). Care recipients were likely to be community-dwelling parents (71%), with moderate or advanced (79%) dementia. Caregivers described challenges with accessing resources intended for care recipients, especially as cognitive impairment worsened. Caregivers reported providing care 24/7 as traumatizing. Home-based personal aides and companionship services did not reduce this burden. COVID-19 impacted caregivers and care recipient’s access to resources increasing burden. Policies need to be flexible for ever-changing needs of individuals with ADRD and support the overall well-being of the caregivers.

BACKGROUND Scianna (SC) blood group system comprises two antithetical antigens, Sc1 and Sc2, and five additional antigens. The antigens reside on a glycoprotein encoded by the erythroblast membrane–associated protein (ERMAP) gene. For the common ERMAP alleles, we determined the full-length nucleotide sequence that encodes the Scianna glycoprotein. STUDY DESIGN AND METHODS Blood donor samples from five populations were analyzed including 20 African Americans, 10 Caucasians, 10 Thai, five Asians, and five Hispanics for a total of 100 chromosomes. An assay was devised to determine the genomic sequence of the ERMAP gene in one amplicon, spanning 21.4 kb and covering Exons 2 to 12 and the intervening sequence (IVS). All alleles (confirmed haplotypes) were resolved without ambiguity. RESULTS Among 50 blood donors, we found 80 single-nucleotide polymorphisms (SNPs), including six novel SNPs, in 21,308 nucleotides covering the coding sequence of the ERMAP gene and including the introns. The noncoding sequences harbored 75 SNPs (68 in the introns and seven in the 3′-UTR). No SNP indicative of a nonfunctional allele was detected. The nucleotide sequences for 48 ERMAP alleles (confirmed haplotypes) were determined by allele-specific polymerase chain reaction and sequencing in 100 chromosomes. CONCLUSIONS We documented 48 ERMAP alleles of 21,308 nucleotides each. The two nucleotide sequences available in GenBank for ERMAP alleles of similar length have not been found in our 100 chromosomes. Alleles determined without ambiguity can be used as templates to analyze next generation sequencing data, which will enhance the reliability in clinical diagnostics.

Scianna (SC) blood group system comprises two antithetical antigens, Sc1 and Sc2, and five additional antigens. The antigens reside on a glycoprotein encoded by the erythroblast membrane-associated protein (ERMAP) gene. For the common ERMAP alleles, we determined the full-length nucleotide sequence that encodes the Scianna glycoprotein.Blood donor samples from five populations were analyzed including 20 African Americans, 10 Caucasians, 10 Thai, five Asians, and five Hispanics for a total of 100 chromosomes. An assay was devised to determine the genomic sequence of the ERMAP gene in one amplicon, spanning 21.4 kb and covering Exons 2 to 12 and the intervening sequence (IVS). All alleles (confirmed haplotypes) were resolved without ambiguity.Among 50 blood donors, we found 80 single-nucleotide polymorphisms (SNPs), including six novel SNPs, in 21,308 nucleotides covering the coding sequence of the ERMAP gene and including the introns. The noncoding sequences harbored 75 SNPs (68 in the introns and seven in the 3'-UTR). No SNP indicative of a nonfunctional allele was detected. The nucleotide sequences for 48 ERMAP alleles (confirmed haplotypes) were determined by allele-specific polymerase chain reaction and sequencing in 100 chromosomes.We documented 48 ERMAP alleles of 21,308 nucleotides each. The two nucleotide sequences available in GenBank for ERMAP alleles of similar length have not been found in our 100 chromosomes. Alleles determined without ambiguity can be used as templates to analyze next generation sequencing data, which will enhance the reliability in clinical diagnostics.

The Orange County Water District (OCWD) operates a 70-mgd RO system as part of the Groundwater Replenishment System (GWRS), an advanced wastewater purification facility. Each of 15 5-mgd RO units consists of a three-stage array, operating at 85 percent recovery. As part of the operating strategy, antiscalant and pH suppression are used to limit third-stage precipitation of sparingly soluble mineral salts. Identifying successful antiscalants is extremely challenging. A variety of antiscalants with varying chemistries and capabilities present opportunities for optimizing RO processes, pricing, dosage, and pH adjustment. Recognizing the potential savings in RO pretreatment chemical cost, OCWD began antiscalant pilot-scale trials in 2009. However, failure to identify an effective product led to the trial's cancellation. Concurrently, the GWRS RO facility began experiencing third-stage permeability loss in all 15 RO units because the antiscalant was ineffective. This article discusses fast-track testin...

Within the last decade, wastewater reclamation using membrane technologies has become a realistic possibility for many municipalities and a necessity for those located in dry, arid regions. The combination of membrane filtration, reverse osmosis (RO), and advanced oxidation to treat municipal effluents beyond drinking water qualities has been demonstrated as the process of choice for municipalities trying to reduce dependence on potable water for industrial or agricultural uses, implement indirect potable reuse applications, or create direct potable reuse supplies. Three such municipalities—West Basin Municipal Water District, Carson, Calif.; Orange County Water District, Fountain Valley, Calif; and the Western Corridor Recycled Water Project, Brisbane, Queensland, Australia—have employed this advanced treatment process on their local wastewater effluents for a variety of uses, but their common goal is to sustain local potable water supplies. This article compares operational data and performance ...

Please click here to download the map associated with this article. Pedestrian accessibility maps often display a Euclidean distance (straight line between two points) buffer around a destination. This paper presents a map that demonstrates how a pedestrian network can be used to improve the accuracy of these results and model the effect of gradient and demographics on walk speed. A bespoke GIS model was developed to undertake the assessment, which is explained along with the key assumptions made. The model was used to assess pedestrian access levels from five proposed development sites in the West Northamptonshire area to the key local facilities. The results quantified access using defined threshold journey times to provide the percentage of dwellings within this limit. This helped West Northamptonshire Development Corporation to consider the specific pedestrian access issues that each site may have, which forms part of their process of delivering sustainable development. The model developed co...

Orange County (Calif.) Water District (OCWD) performed an economic analysis to determine the most effective cleaning interval for the reverse osmosis (RO) membranes in its Groundwater Replenishment System (GWRS), which consists of 26 microfiltration (MF) cells operating polypropylene membranes at 20 gfd (34 lmh) and more than 90 percent recovery. The MF system has a filtrate capacity of 86 mgd (325 MLD). Each cell houses 608 submodules. An RO system consists of 15 5-mgd (19 MLD) trains for a total of 70 mgd (265 MLD) RO permeate capacity. The RO trains operate at 85 percent recovery and maximum permeate flux of 12 gfd (20.4 lmh). Each train houses 1,050 8- × 40-in. high-productivity RO membrane elements in a 78:48:24 array. OCWD staff analyzed optimum operation intervals between cleanings based on the energy required to operate each train.

Although flexible ureteroscopes are designed with mechanisms for active and passive tip deflection, one of the major problems is the not infrequent inability to enter the lower pole calices. Accordingly, we measured the change in the lower pole infundibulopelvic (LIP) angle when the patient's position was varied (i.e., prone, supine, head down) during intravenous urography (IVU).The LIP angle was measured in 20 right and 26 left adult kidneys during an IVU with the patient in six different positions: supine level, supine 20 degrees head down, supine 45 degrees head up, prone level, prone 20 degrees head down, and prone 45 degrees head up. None of the patients had a history of renal surgery.In all cases, the broadest angle of entry to the lower pole infundibulum was obtained with the patient in a prone position and 20 degrees head down.The LIP angle broadens when the patient lies in a prone 20 degrees head down position. This maneuver could improve the surgeon's ability to access the lower pole calices when performing flexible ureteronephroscopy.