Refractory cachexia and truth-telling about terminal prognosis; A qualitative study

The purpose of this paper is to examine the consequences that medical practitioners’ decisions about whether or not to be candid about terminal prognosis have for those suffering from refractory cachexia and their families. It presents the findings of a qualitative study which used focus groups and semi-structured interviews of a volunteer sample of doctors, nurses and dieticians in a cancer centre of a large teaching hospital in Northern Ireland. Respondents reported that some physicians tended to avoid discussing terminal prognosis in a direct manner with their patients. Nurses and dieticians tended to be reluctant to engage in conversations about weight loss with patients with cachexia. One of the reasons they reported for their lack of acknowledgement of weight loss concerned the close association between refractory cachexia and terminal prognosis. Because they viewed the telling of bad news as an exclusive prerogative of medical practitioners, they did not feel in a position to discuss cachexia because they were concerned that this had the potential to raise end-of-life issues that lay outside the boundaries of their professional role. This meant patients and their families were provided with little information about how to cope with the distressing consequences of cachexia.

British population and society in 2025:Some conjectures

The paper examines three aspects of demographic change and conjectures about their wider impact on British society. Two features of fertility behaviour are highlighted. The first deals with ethnic variations and the likely continuation of high fertility rates amongst women of South Asian origin. The second involves the continued bifurcation between career women and those for whom motherhood remains a central life project. International migration is also assessed and the contradictions within the 'Fortress Britain' strategy exposed. Britain will continue to receive migrants from overseas and British society will become increasingly multi-ethnic. The paper also examines the tensions between an increasingly ageing population and the development of increased ethnic and cultural diversity. The paper concludes with some implications of these changes for the discipline of sociology itself.

Getting In and Getting On? The Experiences of Young People with Visual Impairments and Hearing Impairments in Third-Level Education

Young disabled people continue to be under-represented throughout further and higher education settings. Drawing on Pierre Bourdieu’s social theory of habitus, capital and field, this paper explores the practices of domination and oppression that have made it difficult for young people with visual impairments and hearing impairments to participate in third-level education on the same basis as non-disabled people. Twenty young people with hearing impairments and visual impairments were interviewed about their educational experiences. In addition, 31 interviews were conducted with third-level education providers, policy-makers and non-governmental organisations. This article has two aims: firstly, to critically examine the experiences of young people with hearing impairments and visual impairments in accessing and engaging with support provisions in further and higher education settings; and secondly, to identify and explore the diversity of ways in which these young people have managed and responded to the practices they have encountered. This article emphasises the journey from ability to dis-ability that young people with hearing and visual impairments experience in their quest for educational achievement. The ambiguities of “inclusion”, “widening participation” and “support” are highlighted and critiqued for their extensive failure to challenge taken-for-granted discourses.

Life history of turbot in Icelandic waters: Intra- and inter-population genetic diversity and otolith tracking of environmental temperatures

The stock structure of turbot was investigated between samples from S-Norway, the Irish Sea and the Kattegat, using 12 microsatellite loci and compared to the turbot caught in Icelandic waters. Highly significant genetic differentiation was observed between samples from Kattegat and other areas. Significant genetic differentiation was also observed between the Irish Sea sample on one hand and Iceland and S-Norway on the other hand. No significant genetic differentiation was observed between Iceland and S-Norway. Otoliths of 25 turbot, age ranging from 3 to 19 years, were subjected to nearly 300 mass spectrometry determinations of stable oxygen and carbon isotopes. Oxygen isotope composition (δ¹⁸O) in the otolith samples was used to estimate ambient temperature at time of otolith accretion, and yielded estimated temperatures experienced by the turbot ranging from 3 to 15°C. Overall, the genetic analysis indicates panmixia between turbot in Icelandic and Norwegian waters. While the extensive migration of larvae between Norway and Iceland is unlikely, passive drift of turbot larva from other areas (e.g. Ireland) cannot be ruled out. 

Switched Diversity Techniques for Indoor Off-body Communications Channels: An Experimental Analysis and Modeling

This paper investigates the potential improvement in signal reliability for indoor off-body communications channels operating at 5.8 GHz using switched diversity techniques. In particular we investigate the performance of switch-and-stay combining (SSC), switch-and-examine combining (SEC) and switch-and-examine combining with post-examining selection (SECps) schemes which utilize multiple spatially separated antennas at the base station. During the measurements a test subject, wearing an antenna on his chest, performed a number of walking movements towards and then away from a uniform linear array. It was found that all of the considered diversity schemes provided a worthwhile signal improvement. However, the performance of the diversity systems varied according to the switching threshold that was adopted. To model the fading envelope observed at the output of each of the combiners, we have applied diversity specific equations developed under the assumption of Nakagami-$m$ fading. As a measure of the goodness-of-fit, the Kullback-Leibler divergence between the empirical and theoretical probability density functions (PDFs) was calculated and found to be close to 0. To assist with the interpretation of the goodness-of-fit achieved in this study, the standard deviation, $\sigma$, of a zero-mean, $\sigma^2$ variance Gaussian PDF used to approximate a zero-mean, unit variance Gaussian PDF is also presented. These were generally quite close to 1 indicating that the theoretical models provided an adequate fit to the measured data.