Impact of counselling on quality of life and sleep in cancer patients

It has been acknowledged that poor quality of sleep significantly correlates with poor quality of life; evidence suggests that counselling has a positive impact not only on the cancer patient's quality of life, but also on family members and friends. The aim of this service evaluation was to determine if there was an improvement in clients’ quality of life and sleep patterns following counselling as offered by a local cancer charity. A total of 60 matched pre- and post-counselling questionnaires were completed and subjected to statistical analysis. When considering quality of life, in the domains of Role Emotional, Mental Health and Mental Component Summary Score, it can be concluded that counselling has a positive effect on emotional health and mental wellbeing. The mean total number of hours sleep per night significantly increased from 6 hours sleep per night at baseline to 6.8 hours sleep per night at the completion of counselling (p=0.005) showing clients gained an extra 48 minutes sleep per night. The improved emotional and mental wellbeing alongside the extra 48 minutes sleep per night provides evidence that there is a positive outcome for those patients and families who use counselling services. Nurses and other members of the multidisciplinary team should be encouraged to discuss supportive therapies with patients and those affected by cancer at all stages of the cancer trajectory, regardless of social status, gender or cancer type.

Response of farmland biodiversity to the introduction of bioenergy crops: effects of local factors and surrounding landscape context

The recent growth in bioenergy crop cultivation, stimulated by the need to implement measures to reduce net CO emissions, is driving major land-use changes with consequences for biodiversity and ecosystem service provision. Although the type of bioenergy crop and its associated management is likely to affect biodiversity at the local (field) scale, landscape context and its interaction with crop type may also influence biodiversity on farms. In this study, we assessed the impact of replacing conventional agricultural crops with two model bioenergy crops (either oilseed rape Brassica napus or Miscanthus × giganteus) on vascular plant, bumblebee, solitary bee, hoverfly and carabid beetle richness, diversity and abundance in 50 sites in Ireland. We assessed whether within-field biodiversity was also related to surrounding landscape structure. We found that local- and landscape-scale variables correlated with biodiversity in these agricultural landscapes. Overall, the differences between the bioenergy crops and the conventional crops on farmland biodiversity were mostly positive (e.g. higher vascular plant richness in Miscanthus planted on former conventional tillage, higher solitary bee abundance and richness in Miscanthus and oilseed rape compared with conventional crops) or neutral (e.g. no differences between crop types for hoverflies and bumblebees). We showed that these crop type effects were independent of (i.e. no interactions with) the surrounding landscape composition and configuration. However, surrounding landscape context did relate to biodiversity in these farms, negatively for carabid beetles and positively for hoverflies. Although we conclude that the bioenergy crops compared favourably with conventional crops in terms of biodiversity of the taxa studied at the field scale, the effects of large-scale planting in these landscapes could result in very different impacts. Maintaining ecosystem functioning and the delivery of ecosystem services will require a greater understanding of impacts at the landscape scale to ensure the sustainable development of climate change mitigation measures.

Investigating the Potential Impact of Four-dimensional Computed Tomography (4DCT) on Toxicity, Outcomes and Dose Escalation for Radical Lung Cancer Radiotherapy

AIMS: To investigate the potential dosimetric and clinical benefits predicted by using four-dimensional computed tomography (4DCT) compared with 3DCT in the planning of radical radiotherapy for non-small cell lung cancer.

MATERIALS AND METHODS:
Twenty patients were planned using free breathing 4DCT then retrospectively delineated on three-dimensional helical scan sets (3DCT). Beam arrangement and total dose (55 Gy in 20 fractions) were matched for 3D and 4D plans. Plans were compared for differences in planning target volume (PTV) geometrics and normal tissue complication probability (NTCP) for organs at risk using dose volume histograms. Tumour control probability and NTCP were modelled using the Lyman-Kutcher-Burman (LKB) model. This was compared with a predictive clinical algorithm (Maastro), which is based on patient characteristics, including: age, performance status, smoking history, lung function, tumour staging and concomitant chemotherapy, to predict survival and toxicity outcomes. Potential therapeutic gains were investigated by applying isotoxic dose escalation to both plans using constraints for mean lung dose (18 Gy), oesophageal maximum (70 Gy) and spinal cord maximum (48 Gy).

RESULTS:
4DCT based plans had lower PTV volumes, a lower dose to organs at risk and lower predicted NTCP rates on LKB modelling (P < 0.006). The clinical algorithm showed no difference for predicted 2-year survival and dyspnoea rates between the groups, but did predict for lower oesophageal toxicity with 4DCT plans (P = 0.001). There was no correlation between LKB modelling and the clinical algorithm for lung toxicity or survival. Dose escalation was possible in 15/20 cases, with a mean increase in dose by a factor of 1.19 (10.45 Gy) using 4DCT compared with 3DCT plans.

CONCLUSIONS:
4DCT can theoretically improve therapeutic ratio and dose escalation based on dosimetric parameters and mathematical modelling. However, when individual characteristics are incorporated, this gain may be less evident in terms of survival and dyspnoea rates. 4DCT allows potential for isotoxic dose escalation, which may lead to improved local control and better overall survival.

Assessing the distribution of social-ecological resilience and risk: Ireland as a case study of the uneven impact of famine

Explanations for the causes of famine and food insecurity often reside at a high level of aggregation or abstraction. Popular models within famine studies have often emphasised the role of prime movers such as population stress, or the political-economic structure of access channels, as key determinants of food security. Explanation typically resides at the macro level, obscuring the presence of substantial within-country differences in the manner in which such stressors operate. This study offers an alternative approach to analyse the uneven nature of food security, drawing on the Great Irish famine of 1845–1852. Ireland is often viewed as a classical case of Malthusian stress, whereby population outstripped food supply under a pre-famine demographic regime of expanded fertility. Many have also pointed to Ireland's integration with capitalist markets through its colonial relationship with the British state, and country-wide system of landlordism, as key determinants of local agricultural activity. Such models are misguided, ignoring both substantial complexities in regional demography, and the continuity of non-capitalistic, communal modes of land management long into the nineteenth century. Drawing on resilience ecology and complexity theory, this paper subjects a set of aggregate data on pre-famine Ireland to an optimisation clustering procedure, in order to discern the potential presence of distinctive social–ecological regimes. Based on measures of demography, social structure, geography, and land tenure, this typology reveals substantial internal variation in regional social–ecological structure, and vastly differing levels of distress during the peak famine months. This exercise calls into question the validity of accounts which emphasise uniformity of structure, by revealing a variety of regional regimes, which profoundly mediated local conditions of food security. Future research should therefore consider the potential presence of internal variations in resilience and risk exposure, rather than seeking to characterise cases based on singular macro-dynamics and stressors alone.

Open Data: European Ambitions and Local Efforts. Experiences from Austria

The member states of the European Union are faced with the challenges of handling “big data” as well as with a growing impact of the supranational level. Given that the success of efforts at European level strongly depends on corresponding national and local activities, i.e., the quality of implementation and the degree of consistency, this chapter centers upon the coherence of European strategies and national implementations concerning the reuse of public sector information. Taking the City of Vienna’s open data activities as an illustrative example, we seek an answer to the question whether and to what extent developments at European level and other factors have an effect on local efforts towards open data. We find that the European Commission’s ambitions are driven by a strong economic argumentation, while the efforts of the City of Vienna have only very little to do with the European orientation and are rather dominated by lifestyle and administrative reform arguments. Hence, we observe a decoupling of supranational strategies and national implementation activities. The very reluctant attitude at Austrian federal level might be one reason for this, nationally induced barriers—such as the administrative culture—might be another. In order to enhance the correspondence between the strategies of the supranational level and those of the implementers at national and regional levels, the strengthening of soft law measures could be promising.

Impact of composite ply continuity constraints on aerospace stiffened panel design

Considering the development of aerospace composite components, designing for reduced manufacturing layup cost and structural complexity is increasingly important. While the advantage of composite materials is the ability to tailor designs to various structural loads for minimum mass, the challenge is obtaining a design that is manufacturable and minimizes local ply incompatibility. The focus of the presented research is understanding how the relationships between mass, manufacturability and design complexity, under realistic loads and design requirements, can be affected by enforcing ply continuity in the design process. Presented are a series of sizing case studies on an upper wing cover, designed using conventional analyses and the tabular laminate design process. Introducing skin ply continuity constraints can generate skin designs with minimal ply discontinuities, fewer ply drops and larger ply areas than designs not constrained for continuity. However, the reduced design freedom associated with the addition of these constraints results in a weight penalty over the total wing cover. Perhaps more interestingly, when considering manual hand layup the reduced design complexity is not translated into a reduced recurring manufacturing cost. In contrast, heavier wing cover designs appear to take more time to layup regardless of the laminate design complexity. © 2012 AIAA.

Protecting Natura 2000: Avoiding Adverse Impact on European Sites

Case C-258/11 Peter Sweetman, Ireland, Attorney General, Minister for the Environment, Heritage and Local Government v An Bord Pleanála
(Not yet reported)

The impact of climate change on existing and emerging microbial threats across the food chain: an island of Ireland perspective

The Agri-Food and aquaculture industries are vital to the economy of the island of Ireland with a gross annual output that is expected to double in the future. Identifying and understanding the potential influences of the anticipated climate variables on microorganisms that cause foodborne diseases, and their impact on these local industries, are essential. Investigating and monitoring foodborne pathogens and factors that influence their growth, transmission, pathogenesis and survival will facilitate assessment of the stability, security and vulnerability of the continuously evolving and increasing complex local food supply chain.

Impact of finite element idealisation on the prediction of welded fuselage stiffened panel buckling

Lap joints are widely used in the manufacture of stiffened panels and influence local panel sub-component stability, defining buckling unit dimensions and boundary conditions. Using the Finite Element method it is possible to model joints in great detail and predict panel buckling behaviour with accuracy. However, when modelling large panel structures such detailed analysis becomes computationally expensive. Moreover, the impact of local behaviour on global panel performance may reduce as the scale of the modelled structure increases. Thus this study presents coupled computational and experimental analysis, aimed at developing relationships between modelling fidelity and the size of the modelled structure, when the global static load to cause initial buckling is the required analysis output. Small, medium and large specimens representing welded lap-joined fuselage panel structure are examined. Two element types, shell and solid-shell, are employed to model each specimen, highlighting the impact of idealisation on the prediction of welded stiffened panel initial skin buckling.

Numerical analysis of impact events in a centrifugal impact pin mill

Milling is an important operation in many industries, such as mining and pharmaceutical. Although the comminution process during milling has been extensively studied, the material fragmentation mechanisms in a mill are still not well understood partly because of the lack of an understanding on the local stressing and dynamic information under operational conditions in mills. This paper presents a DEM simulation of particle dynamics and impact events in a centrifugal impact pin mill. The main focus is the statistical characteristics of the dominant stressing modes during the milling process. The frequency, velocity and force of the different impact events between particles and mill components, or between particles, are analysed. © 2013 AIP Publishing LLC.

VentBase:Developing a consensus among stakeholders in the deep-sea regarding environmental impact assessment for deep-sea mining-A workshop report

Mining seafloor massive sulfides for metals is an emergent industry faced with environmental management challenges. These revolve largely around limits to our current understanding of biological variability in marine systems, a challenge common to all marine environmental management. VentBase was established as a forum where academic, commercial, governmental, and non-governmental stakeholders can develop a consensus regarding the management of exploitative activities in the deep-sea. Participants advocate a precautionary approach with the incorporation of lessons learned from coastal studies. This workshop report from VentBase encourages the standardization of sampling methodologies for deep-sea environmental impact assessment. VentBase stresses the need for the collation of spatial data and importance of datasets amenable to robust statistical analyses. VentBase supports the identification of set-asides to prevent the local extirpation of vent-endemic communities and for the post-extraction recolonization of mine sites. © 2013.

Distribution and visual impact of postoperative refractive error after cataract surgery in rural China: study of cataract outcomes and up-take of services report 4.

PURPOSE: To model the possible impact of using average-power intraocular lenses (IOLs) and evaluate the postoperative refractive error in patients having cataract surgery in rural China.SETTING: Rural Guangdong, China.METHODS: Patients having cataract surgery by local surgeons were examined and visual function was assessed 10 to 14 months after surgery. Subjective refraction at near and distance was performed bilaterally by an ophthalmologist. Patients had a target refraction of -0.50 diopter (D) based on ocular biometry.RESULTS: Of the 313 eligible patients, 242 (77%) could be contacted and 176 (74% of contacted patients, 56% overall) were examined. Examined patients had a mean age of 69.4 +/- 10.5 years. Of the 211 operated eyes, 73.2% were within +/-1.0 D of the target refraction after surgery. The best presenting distance vision was in patients within +/-1.0 D of plano and the best presenting near vision, in those with mild myopia (<-1.0 D to > or =2.0 D) (P= .005). However, patients with hyperopia (>+1.0 D) reported significantly better adjusted visual function than those with emmetropia or myopia (<-1.0 D). When the predicted use of an average-power IOL (median +21.5 D) was modeled, predicted visual acuity was significantly reduced (P= .001); however, predicted visual function was not significantly altered (P>.3).CONCLUSIONS: Accurate selection of postoperative refractive error was achieved by local surgeons in this rural area. Based on visual function results, aiming for mild postoperative myopia may not be suitable in this setting. Implanting average-power IOLs significantly reduced postoperative presenting vision, but not visual function.

Impact of posterior subcapsular opacification on vision and visual function among subjects undergoing cataract surgery in rural China: Study of Cataract Outcomes and Up-Take of Services (SCOUTS) in the Caring is Hip Project, report 5.

AIM: To study the effect of posterior capsular opacification (PCO) on vision and visual function in patients undergoing cataract surgery in rural China, and to compare this with the effect of refractive error. METHODS: Patients undergoing cataract surgery in at least one eye by local surgeons in a rural setting between 8 August and 31 December 2005 were examined with slit lamp grading of PCO 10-14 months after surgery. Subjects with any PCO associated with best-corrected visual acuity of 6/7.5 or worse, or with grade 2+ or worse PCO without visual decrement, were offered YAG laser capsulotomy. Vision and self-reported visual function were assessed, and various demographic and clinical factors potentially associated with PCO were recorded. RESULTS: Of 313 patients operated on within the study window, 239 (76%) could be contacted by telephone; study examinations were performed on 176 (74%). Examined subjects had a mean (SD) age of 69.4 (10.5) years, 116 (67%) were female, and 149 (86%) had been blind (presenting visual acuity < or = 6/60) in the operated eye before surgery. PCO of grade 1 or above was present in 34 of 204 operated eyes (16.7%). Those with PCO had significantly worse presenting vision (p = 0.007) but not visual function (p>0.3) than those without PCO. Women had a significantly higher prevalence of PCO (20.9%) than did men (8.6%, p<0.05). Of 19 eyes undergoing capsulotomy with best-corrected visual acuity measured the next day, 13 (68%) improved by one or more lines, and seven (37%) improved by two or more lines. Despite a higher uptake of capsulotomy (95%) as opposed to refraction (35%) in this cohort, the yield in terms of eyes with poor presenting visual acuity (< 6/18) that could be improved was higher for refraction (26% = 9/35) than for capsulotomy (9% = 3/35). CONCLUSION: The prevalence of PCO and impact on vision and visual function in this cohort was modest 1 year after surgery. However, PCO prevalence increases with time. Follow-up of this cohort is underway to determine the effectiveness of this early intervention in identifying and treating subjects who will eventually experience clinically significant PCO.

Exploiting local controversy: regional British censorship of Last Tango in Paris (1972)

This article explores local authority responses to the cinematic release of Last Tango in Paris in Britain. Using a range of archival material from the BBFC, the National Archives and the Public Records Office of Northern Ireland, it offers a detailed, comparative case study of three different locations; Belfast, Newport and Oxford. It argues that comparing local censorship decisions with the national decisions of the BBFC offer little in the way of regional nuance. In order to effectively understand the workings of local censorship, a deeper understanding of local discourses is needed as well as acknowledgement of broader pressure group activity and its impact on the local picture, such as that of the National Festival of Light.

Electron-impact excitation of Fe2: a comparison of intermediate coupling frame transformation, Breit-Pauli and Dirac R-matrix calculations

Modeling the spectral emission of low-charge iron group ions enables the diagnostic determination of the local physical conditions of many cool plasma environments such as those found in H II regions, planetary nebulae, active galactic nuclei etc. Electron-impact excitation drives the population of the emitting levels and, hence, their emissivities. By carrying-out Breit-Pauli and intermediate coupling frame transformation (ICFT) R-matrix calculations for the electron-impact excitation of Fe$^{2+}$ which both use the exact same atomic structure and the same close-coupling expansion, we demonstrate the validity of the application of the powerful ICFT method to low-charge iron group ions. This is in contradiction to the finding of Bautista et al. [Ap.J.Lett, 718, L189, (2010)] who carried-out ICFT and Dirac R-matrix calculations for the same ion. We discuss possible reasons.