The late effects of cancer and cancer treatment:a rapid review

This paper aims to synthesize literature about the definition, prevalence, onset and treatments associated with late effects. A rapid review was conducted using Google Scholar to identify reviews related to the late effects of adult-onset cancers. Papers were included if they provided a definition of late effects and/or presented a review of late effects as a result of adult-onset cancers in patients aged 18 years or older. Reviews related to nonmelanoma skin cancer were excluded. Reviews focusing on late effects in survivors of childhood-onset cancers (younger than 18 years) were ineligible for inclusion in the review. A total of 16 reviews were identified. Between 0% and 100% of survivors experienced a range of physical, psychological and social late effects. The onset of physical late effects was defined broadly as 'months or years' after treatment, whereas psychological late effects were defined as occurring at the end of treatment or similarly to physical late effects as 'months or years' after treatment. Few reviews provided an operational definition of late effects, and the onset of late effects was not often reported. Thus, reviews may have included the acute and long-term effects of cancer treatment. Evidence regarding causes, prevalence, and onset was incomplete for many late effects. Understanding the cause and onset of late effects is important in order to provide timely interventions to reduce the risk of late effect development in cancer patients.

Human Resource Management in Multinational Enterprises: Evidence From a Late Industrializing Economy

This paper examines the extent to which human resource management (HRM) practices in multinational enterprises (MNEs) from a small, late developing and highly globalized economy resemble their counterparts from larger, early industrializing countries. The paper draws on data from a large-scale representative survey of 260 MNEs in Ireland. The results demonstrate that there are significant differences between the HRM practices deployed in Irish-owned MNEs and that of their US counterparts but considerable similarity with UK firms. A key conclusion is that arguments in the literature regarding MNEs moving towards the adoption of global best practices, equating to the pursuance of an American model of HRM, were not obvious. The study found considerable variation from ‘US practices’ amongst indigenous Irish MNEs.

Land, Popular Politics and Agrarian Violence in Late Nineteenth Century Ireland

"Land, Popular Politics and Agrarian Violence in Ireland" provides an original and insightful study of the highly formative Land War and Home Rule from a local and regional perspective. Lucey examines the emergence and development of the largest mass political mobilisation brought about in nineteenth-century Ireland in the form of the Land League, and subsequently the National League, in the south-western county of Kerry. Such an unprecedented level of local political activity was matched by an upsurge in agrarian violence and the outbreak of serious outrage, which was largely orchestrated by secret societies known as Moonlighters. In turn, this book provides an important exploration of the dynamics behind the mass political mobilisation and agrarian violence that dominated Kerry society during the 1880s. The role of Fenians, radical agrarian agitators and moderate constitutional nationalists are all examined within the county.This study has importance beyond the local and provides a range of insights into motivations behind political action and violence at an everyday level during one of the most seminal and transformative eras in the development of modern Irish history. This title is suitable for students and academics of nineteenth-century Irish history and general readers.

An archaeological approach to the development of the late medieval peasant house

Archaeological excavation has provided an alternative source of evidence for the development of the late medieval peasant house. It is argued that whilst there was a significant change in building techniques in the decades around 1200 with the adoption of ground-set timbers, the most important factor which led to the survival of houses was a fall in real wages during the thirteenth century. This encouraged peasants to repair existing buildings, rather than replace them with new ones. Alternative traditions of building are also investigated. Stone construction was adopted in a number of areas of England, but in spite of the durability of the material, few medieval peasant buildings of this type have survived in use because of the failure to use lime mortar. Decisions about whether to invest in a building’s renovation will depend on the capital initially expended upon it. This interpretation is considered against the data from the fifteenth century and found to conform satisfactorily. Its implications are considered for the period between 1200 and 1350. Data collected from archaeological excavations combined with the results of dendrochronology on a growing number of closely dated standing buildings suggest that there was a significant ‘cull’ of houses in the period after 1350 as new dwellings were constructed.

Quantitative Measurement of [Na+] and [K+] in Postmortem Human Brain Tissue Indicates Disturbances in Subjects with Alzheimer's Disease and Dementia with Lewy Bodies

Alzheimer’s disease (AD) is associated with significant disturbances in the homeostasis of Na+ and K+ ions as well as reduced levels of Na+/K+ ATPase in the brain. This study used ICP-MS to accurately quantify Na+ and K+ concentrations in human postmortem brain tissue. We analyzed parietal cortex (Brodmann area 7) from 28 cognitively normal age-matched controls, 15 cases of moderate AD, 30 severe AD, and 15 dementia with Lewy bodies (DLB). Associations were investigated between [Na+] and [K+] and a number of variables including diagnosis, age, gender, Braak tangle stage, amyloid-β (Aβ) plaque load, tau load, frontal tissue pH, and APOE genotype. Brains from patients with severe AD had significantly higher (26%; p<0.001) [Na+] (mean 65.43 ± standard error 2.91 mmol/kg) than controls, but the concentration was not significantly altered in moderate AD or DLB. [Na+] correlated positively with Braak stage (r=0.45; p<0.0001), indicating association with disease severity. [K+] in tissue was 10% lower (p<0.05) in moderate AD than controls. However, [K+] in severe AD and DLB (40.97±1.31 mmol/kg) was not significantly different from controls. There was a significant positive correlation between [K+] and Aβ plaque load (r=0.46; p=0.035), and frontal tissue pH (r=0.35; p=0.008). [Na+] was not associated with [K+] across the groups, and neither ion was associated with tau load or APOE genotype. We have demonstrated disturbances of both [Na+] and [K+] in relation to the severity of AD and markers of AD pathology, although it is possible that these relate to late-stage secondary manifestations of the disease pathology.

New age estimates and climatostratigraphic correlations for the Borrobol and Penifiler Tephras: evidence from Abernethy Forest, Scotland

The emerging tephrostratigraphy of NW Europe spanning the last termination (ca. 15–9 ka) provides the potential for synchronizing marine, ice-core and terrestrial records, but is currently compromised by stratigraphic complications, geochemical ambiguity and imprecise age estimates for some layers. Here we present new tephrostratigraphic, radiocarbon and chironomid-based
palaeotemperature data from Abernethy Forest, Scotland, that refine the ages and stratigraphic positions of the Borrobol and Penifiler tephras. The Borrobol Tephra (14.14–13.95 cal ka BP) was deposited in a relatively warm period equated with Greenland Interstadial sub-stage GI-1e. The younger Penifiler Tephra (14.09–13.65 cal ka BP) is closely associated with a cold oscillation equated with GI-
1d. We also present evidence for a previously undescribed tephra layer that has a major-element chemical signature identical to the Vedde Ash. It is associated with the warming trend at the end of the Younger Dryas, and dates between 11.79 and 11.20 cal ka BP.

The European Union: Emerging from Crisis?

The Eurozone turmoil might have calmed, but the EU is still trying to free itself from a crisis that has had a dramatic impact on citizens’ economic and social well-being and raised serious questions about the union's future. David Phinnemore reports.

Cancer survivors with self-reported late effects: their health status, care needs and service utilisation

OBJECTIVE: Cancer survivors (CSs) are at risk of developing late effects (LEs) associated with the disease and its treatment. This paper compares the health status, care needs and use of health services by CSs with LEs and CSs without LEs.

METHODS: Cancer survivors (n = 613) were identified via the Northern Ireland Cancer Registry and invited to participate in a postal survey that was administered by their general practitioner. The survey assessed self-reported LEs, health status, health service use and unmet care needs. A total of 289 (47%) CSs responded to the survey, and 93% of respondents completed a LEs scale.

RESULTS: Forty-one per cent (111/269) of CSs reported LEs. Survivors without LEs and survivors with LEs were comparable in terms of age and gender. The LEs group reported a significantly greater number of co-morbidities, lower physical health and mental health scores, greater overall health service use and more unmet needs. Unadjusted logistic regression analysis found that cancer site, time since diagnosis and treatment were significantly associated with reporting of LEs. CSs who received combination therapies compared with CSs who received single treatments were over two and a half times more likely to report LEs (OR = 2.63, 95% CI = 1.32-5.25) after controlling for all other variables.

CONCLUSIONS: The CS population with LEs comprises a particularly vulnerable group of survivors who have multiple health care problems and needs and who require tailored care plans that take account of LEs and their impact on health-related quality of life.

Pseudomonas aeruginosa exhibits frequent recombination, but only a limited association between genotype and ecological setting

Pseudomonas aeruginosa is an opportunistic pathogen and an important cause of infection, particularly amongst cystic fibrosis (CF) patients. While specific strains capable of patient-to-patient transmission are known, many infections appear to be caused by unique and unrelated strains. There is a need to understand the relationship between strains capable of colonising the CF lung and the broader set of P. aeruginosa isolates found in natural environments. Here we report the results of a multilocus sequence typing (MLST)-based study designed to understand the genetic diversity and population structure of an extensive regional sample of P. aeruginosa isolates from South East Queensland, Australia. The analysis is based on 501 P. aeruginosa isolates obtained from environmental, animal and human (CF and non-CF) sources with particular emphasis on isolates from the Lower Brisbane River and isolates from CF patients obtained from the same geographical region. Overall, MLST identified 274 different sequence types, of which 53 were shared between one or more ecological settings. Our analysis revealed a limited association between genotype and environment and evidence of frequent recombination. We also found that genetic diversity of P. aeruginosa in Queensland, Australia was indistinguishable from that of the global P. aeruginosa population. Several CF strains were encountered frequently in multiple ecological settings; however, the most frequently encountered CF strains were confined to CF patients. Overall, our data confirm a non-clonal epidemic structure and indicate that most CF strains are a random sample of the broader P. aeruginosa population. The increased abundance of some CF strains in different geographical regions is a likely product of chance colonisation events followed by adaptation to the CF lung and horizontal transmission among patients.

Interspecific competition in honeybee intracellular gut parasites is asymmetric and favours the spread of an emerging infectious disease

There is increasing appreciation that hosts in natural populations are subject to infection by multiple parasite species. Yet the epidemiological and ecological processes determining the outcome of mixed infections are poorly understood. Here, we use two intracellular gut parasites (Microsporidia), one exotic and one co-evolved in the western honeybee (Apis mellifera), in an experiment in which either one or both parasites were administered either simultaneously or sequentially. We provide clear evidence of within-host competition; order of infection was an important determinant of the competitive outcome between parasites, with the first parasite significantly inhibiting the growth of the second, regardless of species. However, the strength of this ‘priority effect’ was highly asymmetric, with the exotic Nosema ceranae exhibiting stronger inhibition of Nosema apis than vice versa. Our results reveal an unusual asymmetry in parasite competition that is dependent on order of infection. When incorporated into a mathematical model of disease prevalence, we find asymmetric competition to be an important predictor of the patterns of parasite prevalence found in nature. Our findings demonstrate the wider significance of complex multi-host–multi-parasite interactions as drivers of host–pathogen community structure