Becoming pregnant: exploring the perspectives of women living with diabetes

Background The risk of adverse pregnancy outcome for women with type 1 diabetes is reduced through tight diabetes control. Most women enter pregnancy with inadequate blood glucose control. Interview studies with women suggest the concept of ‘planned’ and ‘unplanned’ pregnancies is unhelpful. Aim To explore women's accounts of their journeys to becoming pregnant while living with type 1 diabetes. Design of study Semi-structured interviews with 15 women living with pre-gestational type 1 diabetes, between 20 and 30 weeks gestation and with a normal pregnancy ultrasound scan. Setting Four UK specialist diabetes antenatal clinics. Method Interviews explored women's journeys to becoming pregnant and the impact of health care. Analysis involved comparison of women's accounts of each pregnancy and a thematic analysis. Results Women's experiences of becoming pregnant were diverse. Of the 40 pregnancies described, at least one positive step towards becoming pregnant was taken by 11 women in 23 pregnancies but not in the remaining 17 pregnancies, with variation between pregnancies. Prior to and in early pregnancy, some women described themselves as experts in their diabetes but most described seeking and/or receiving advice from their usual health professionals. Three women described pre-conception counselling and the anxiety this provoked. Conclusion For women living with type 1 diabetes each pregnancy is different. The concept of planned and unplanned pregnancy is unhelpful for designing health care. Formal preconception counselling can have unintended consequences. Those providing usual care to women are well positioned to provide advice and support to women about becoming pregnant, tailoring it to the changing needs and situation of each woman.

(Para)translated ideologies in Simone de Beauvoir's 'Le deuxième sexe': the (para)translator's role

At the beginning of the 80s new approaches to translation were emerging in such a way that, in the global context of postmodernism and poststructuralism, they provoked a reassessment of Translation Studies (TS), acknowledging ideologies as a relevant concept to TS and considering the political and visible role of the translator. This introduction aims to establish a basic theoretical framework in which we can develop an analysis of the ‘alterations’ that, consciously or unconsciously, translators have imposed on Le deuxième sexe (1949, Gallimard) by Simone de Beauvoir for the last fifty years. Furthermore, it is essential to examine the divergences of the censoring attitude adopted by the first male translators (Parshley, Palant and Milliet) who considered this text to be a sex manual, and the one adopted by more recent female translators (Martorell and Simons) who considered it to be a philosophical book on feminism. Nevertheless, despite this tendency to consider that translators are the only professionals responsible for the translation process, it is necessary to bear in mind the work carried out by the paratranslator, who is the real censor and ‘decider’ of the way a work is presented to the translation community. Paratranslators work with paratexts (also known as ‘analysis-spaces’), and this makes it possible to study the ideological adaptation that a cultural object undergoes when it is incorporated into a new culture and society (covers, volumes, tables of contents, titles, iconic or visual elements and so forth). In short, the analysis of the texts and paratexts of Le deuxième sexe, along with its subsequent translations and rewritings into Spanish, Portuguese and English, will help reveal the function of the censoring apparatus and demonstrate the essential role that –without exception– ideologies play in the professional work of translation and paratranslation, since they have a decisive influence on the reception of the cultural (and ideological) object, in both the society in which it is created and that in which it is received.

A constructive learning algorithm based on back-propagation

There are been a resurgence of interest in the neural networks field in recent years, provoked in part by the discovery of the properties of multi-layer networks. This interest has in turn raised questions about the possibility of making neural network behaviour more adaptive by automating some of the processes involved. Prior to these particular questions, the process of determining the parameters and network architecture required to solve a given problem had been a time consuming activity. A number of researchers have attempted to address these issues by automating these processes, concentrating in particular on the dynamic selection of an appropriate network architecture.The work presented here specifically explores the area of automatic architecture selection; it focuses upon the design and implementation of a dynamic algorithm based on the Back-Propagation learning algorithm. The algorithm constructs a single hidden layer as the learning process proceeds using individual pattern error as the basis of unit insertion. This algorithm is applied to several problems of differing type and complexity and is found to produce near minimal architectures that are shown to have a high level of generalisation ability.

Organisational slack resources, the definitions and consequences for business flexibility and performance : an empirical investigation

Slack resources are recognised to be those spare capabilities and assets of the organisation that are variable reclaimable for re-deployment. They represent under utilised and hidden spare energies within a company that may be recaptured and employed for a variety of tasks. However their positive contribution to organisational success has been a contentious claim that has provoked the intuitive argument that slack resources are inefficiency and are to be eradicated. The counter argument has been that very efficient organisations are inflexible and therefore incapable of being responsive to an increasingly dynamic environment. Therefore this work compares and contrasts three distinctive industries in a holistic manner and maps the impact of environmental flux on the firm, its subsequent disruptive ripples through the organisation and its absorption by slack resources. Through this process it is demonstrated that slack resources do positively contribute to organisational performance and subsequently the ability of slack to promote sustained competitive advantage is also identified. The major findings of this work are listed. 1. This work has developed and perfected a new research model that aids the investigation of the internal behaviours and consequences of Slack Resources. 2. Supported by argument a new variable of Soft Slack was developed. Its validity was demonstrated in its ability to capture the contribution of intangible assets, such as education, experience, spare management time and further training, to the extant levels of Organisational Hard Slack resources. 3. The validity of Soft Slack was further supported when its contribution to organisational Flexibility was also established. 4. The original argument that Slack Resources enhance organisational Performance has been further developed. It is now evidenced that Slack Resources facilitate Organisational Flexibility and by this process enhances Organisational Performance.

How can systematic reviews incorporate qualitative research? A critical perspective

Systematic review has developed as a specific methodology for searching for, appraising and synthesizing findings of primary studies, and has rapidly become a cornerstone of the evidence-based practice and policy movement. Qualitative research has traditionally been excluded from systematic reviews, and much effort is now being invested in resolving the daunting methodological and epistemological challenges associated with trying to move towards more inclusive forms of review. We describe our experiences, as a very diverse multidisciplinary group, in attempting to incorporate qualitative research in a systematic review of support for breastfeeding. We show how every stage of the review process, from asking the review question through to searching for and sampling the evidence, appraising the evidence and producing a synthesis, provoked profound questions about whether a review that includes qualitative research can remain consistent with the frame offered by current systematic review methodology. We conclude that more debate and dialogue between the different communities that wish to develop review methodology is needed, and that attempts to impose dominant views about the appropriate means of conducting reviews of qualitative research should be resisted so that innovation can be fostered. Copyright © 2006 SAGE Publications.

The role of insulin and the insulin-like growth factors in the proliferation of the rat thymic lymphocyte

Concanavalin A, provoked a 35-fold increase in the rate of proliferation of rat thymocytes. Insulin (10-6M), and insulin-like growth factor I (10-10M) approximately doubled the rate of DNA synthesis. Both of these structurally related molecules acted through the type I insulin-like growth factor receptor. The sequential addition of Concanavalin A and insulin, promoted a much greater proliferative response than to either of the two agonists alone. Insulin also increased the uptake of glucose and amino acids by the cells. Glucose uptake was enhanced at insulin concentrations of 10-6M and 10-10M. Amino acid uptake was more strongly affected at the higher concentration. Insulin-like growth factor I (10-11M) also enhanced amino acid uptake. The effects of insulin on metabolism were mediated by both insulin and type I insulin-like growth factor receptors. These effects were greatly enhanced after a pre-treatment with Concanavalin A. Concanavalin A provided a primary mitogenic signal to the cells. Amongst the responses was an increased expression of insulin and/or type I insulin-like growth factor receptors. The consequent enhanced cellular sensitivity to these agonists, enabled them to facilitate the passage of the cells through the cell cycle by: i) providing a secondary mitogenic signal, and ii) promoting the uptake of raw materials and energy substrates. The initiation of DNA synthesis and passage through the cell cycle was thus punctuated by the sequential expression of various cell surface receptors. This regulated cellular sensitivity, enabling them to react in a precisely orchestrated fashion to hormones and other molecules in their environment. The intracellular mechanism of insulin action remains an enigma. Although the presence of extracellular calcium was essential for insulin stimulation of amino acid uptake and DNA synthesis, the cation did not subserve a direct mediator function. Insulin promoted an increase in intracellular pH, which was mediated by the Na+/H+ antiport. Other mechanisms were probably also involved in mediating the full cellular response to insulin.

Androiden und (Anti)feminismus in The Stepford Wives

Since the early days of cinema the creation of artificial life with its various implications has been a popular topic on screen. Amongst the large number of films that deal with the theme of androids Bryan Forbes’ "The Stepford Wives" (1975) is noticeable for its focus on questions of gender and the relationship between the sexes. The film is set in a contemporary small suburban town where frustrated husbands have found a special way of dealing with their emancipated wives by replacing them with docile life-like robots. Mixing elements of the thriller and horror genres with farce and comedy "The Stepford Wives" was the first American mainstream film to deal explicitly with Women’s Lib. Unlike Ira Levin in his much more ambivalent novel that the film was based on, Forbes and his actors deliberately set out to make a feminist satire, and according to some critics succeeded in producing an important document of second wave feminism which soon acquired cult status. However, it also provoked a number of negative reactions from feminists who were very uncomfortable with a film in which men get away with murdering the female population of an entire town. A closer inspection reveals that the satirical element of the film is indeed not prominent and frequently counteracted, at times facilitating a misogynist rather than a feminist interpretation. This is mainly due to the ending of the film which implies the murderous elimination of the female protagonist. Unlike all other cinematic and literary works that feature androids "The Stepford Wives" shows the successful creation of artificial life which does not backfire. In addition, the film which clearly categorises itself as a thriller and horror movie, and specifically alludes to the tradition of threatened yet strong female characters in these genres, at the same time defies this convention in favour of a seemingly misogynist ending. Thus the way in which "The Stepford Wives" refuses to comply with the traditions of both the android theme and the horror genre, involuntarily serves to undermine its intention as a feminist social satire.

Design and development of cationic liposomes as DNA vaccine adjuvants

Cationic liposomes have been extensively explored for their efficacy in delivering nucleic acids, by offering the ability to protect plasmid DNA against degradation, promote gene expression and, in the case of DNA vaccines, induce both humoural and cellular immune responses. DNA vaccines may also offer advantages in terms of safety, but they are less effective and need an adjuvant to enhance their immunogenicity. Therefore, cationic liposomes can be utilised as delivery systems and/or adjuvants for DNA vaccines to stimulate stronger immune responses. To explore the role of liposomal systems within plasmid DNA delivery, parameters such as the effect of lipid composition, method of liposome preparation and presence of electrolytes in the formulation were investigated in characterisation studies, in vitro transfection studies and in vivo biodistribution and immunisation studies. Liposomes composed of 1,2-dioleoyl-sn-glycero 3-phosphoethanolamine (DOPE) in combination with 1,2-dioleoyl-3-trimethylammonium-propane (DOTAP) or 1,2-stearoyl-3- trimethylammonium-propane (DSTAP) were prepared by the lipid hydration method and hydrated in aqueous media with or without presence of electrolytes. Whilst the in vitro transfection efficiency of all liposomes resulted to be higher than Lipofectin, DSTAP-based liposomes showed significantly higher transfection efficiency than DOTAP-based formulations. Furthermore, upon intramuscular injection of liposomal DNA vaccines, DSTAP-based liposomes showed a significantly stronger depot effect at the injection site. This could explain the result of heterologous immunisation studies, which revealed DSTAP-based liposomal vaccines induce stronger immune responses compared to DOTAP-based formulations. Previous studies have shown that having more liposomally associated antigen at the injection site would lead to more drainage of them into the local lymph nodes. Consequently, this would lead to more antigens being presented to antigen presenting cells, which are circulating in lymph nodes, and this would initiate a stronger immune response. Finally, in a comparative study, liposomes composed of dimethyldioctadecylammonium bromide (DDA) in combination with DOPE or immunostimulatory molecule of trehalose 6,6-dibehenate (TDB) were prepared and investigated in vitro and in vivo. Results showed that although DDA:TDB is not able to transfect the cells efficiently in vitro, this formulation induces stronger immunity compared to DDA:DOPE due to the immunostimulatory effects of TDB. This study demonstrated, while the presence of electrolytes did not improve immune responses, small unilamellar vesicle (SUV) liposomes induced stronger humoural immune responses compared to dehydration rehydration vesicle (DRV) liposomes. Moreover, lipid composition was shown to play a key role in in vitro and in vivo behaviour of the formulations, as saturated cationic lipids provided stronger immune responses compared to unsaturated lipids. Finally, heterologous prime/boost immunisation promoted significantly stronger immune responses compared to homologous vaccination of DNA vaccines, however, a single immunisation of subunit vaccine provoked comparable levels of immune response to the heterologous regimen, suggesting more immune efficiency for subunit vaccines compared to DNA vaccines.

„Fern im dänischen Norden ein Bruder”:Thomas Mann und Herman Bang. Eine literarische Spurensuche

This study for the first time demonstrates and analyses the full extent of Danish impressionist writer Herman Bang’s influence on one of Germany’s major authors, Thomas Mann. Mann was an avid reader of Bang’s works and he regarded the Scandinavian writer as a kindred spirit, a “brother up north”, who “taught [him] much”. It has previously been accepted that Bang was an inspiration for Mann in his formative years. However, as this study conclusively shows, references to Bang’s works occur throughout Mann’s writings, from the early novellas to the late novels. The book argues that Mann was not only impressed by Bang’s highly individual style of impressionist writing but that his fascination for Bang’s works was to a large extent based on this author’s recurrent depiction of decadence, his handling of artistic motifs and his treatment of erotic themes. Bang’s topical focus on the problematically isolated lives of artists and aristocrats as well as his insights on the destructive nature of love and sexuality – particularly of homoerotic desire – were surprisingly similar to Mann’s own views on these topics and yet provoked him to produce heavily referenced counter versions of Bang’s works. This phenomenon is explored in the context of Mann’s struggle with his own homosexuality and the attraction that death and decadence exerted over him. Most of Mann’s writings are in that way indebted to Bang. In addition, Mann’s frequent use of homoerotic subtexts and his depiction of female characters were noticeably influenced by Bang’s literary techniques. All these different, yet closely interlinked, aspects of Mann’s creative appropriation of Bang’s works are analysed and discussed in this study. To conclude, Mann’s references to Bang’s works are schematised and an attempt is made to characterise Mann’s intertextual practice in general in the context of his famous use of irony.

Seventeen a-subunit isoforms of paramecium V-ATPase provide high specialization in localization and function

In the Paramecium tetraurelia genome, 17 genes encoding the 100-kDa-subunit (a-subunit) of the vacuolar-proton-ATPase were identified, representing by far the largest number of a-subunit genes encountered in any organism investigated so far. They group into nine clusters, eight pairs with >82% amino acid identity and one single gene. Green fluorescent protein-tagging of representatives of the nine clusters revealed highly specific targeting to at least seven different compartments, among them dense core secretory vesicles (trichocysts), the contractile vacuole complex, and phagosomes. RNA interference for two pairs confirmed their functional specialization in their target compartments: silencing of the trichocyst-specific form affected this secretory pathway, whereas silencing of the contractile vacuole complex-specific form altered organelle structure and functioning. The construction of chimeras between selected a-subunits surprisingly revealed the targeting signal to be located in the C terminus of the protein, in contrast with the N-terminal targeting signal of the a-subunit in yeast. Interestingly, some chimeras provoked deleterious effects, locally in their target compartment, or remotely, in the compartment whose specific a-subunit N terminus was used in the chimera.

Background synaptic activity in rat entorhinal cortical neurones:differential control of transmitter release by presynaptic receptors

The entorhinal cortex (EC) is a key brain area controlling both hippocampal input and output via neurones in layer II and layer V, respectively. It is also a pivotal area in the generation and propagation of epilepsies involving the temporal lobe. We have previously shown that within the network of the EC, neurones in layer V are subject to powerful synaptic excitation but weak inhibition, whereas the reverse is true in layer II. The deep layers are also highly susceptible to acutely provoked epileptogenesis. Considerable evidence now points to a role of spontaneous background synaptic activity in control of neuronal, and hence network, excitability. In the present article we describe results of studies where we have compared background release of the excitatory transmitter, glutamate, and the inhibitory transmitter, GABA, in the two layers, the role of this background release in the balance of excitability, and its control by presynaptic auto- and heteroreceptors on presynaptic terminals. © The Physiological Society 2004.

Investigating ocular allergy:can we determine a better measurement?

Objective: Ocular allergy is a broad group of allergic conditions involving inflammation of the conjunctiva and the most common forms are seasonal allergic conjunctivitis (SAC; 90% of cases) and perennial allergic conjunctivitis (PAC; 5% of cases). The main symptom is ocular itching caused by mast cell degranulation leading to the release of histamine and other mediators such as tryptase. Tryptase is a neutral protease that is selectively concentrated in the secretory granules of human mast cells and has been shown to be a sensitive and specific marker of type I hypersensitivity reaction. The objective was to ascertain the best assay method for determining the tryptase levels in tear samples and whether this can be used to determine the efficacy of non-pharmacological treatments compared to no treatment or their combined effect with anti-allergic medication for SAC and PAC. Method: Thirty patients with a history of SAC were recruited into a randomised blind study during winter months when all the patients were asymptomatic. Suitability was determined by skin prick and conjunctival provocation tests. Patients were randomly assigned to either a non-pharmacological or a pharmacological Intervention group and received each test condition assigned to their group in a randomly assigned order. Symptoms were provoked by exposure to pollen in an environmental test chamber where the temperature, humidity and grass pollen levels were set to a high pollen count day. Tear samples were taken set intervals during the visit and then processed by enzyme linked immunosorbent assay (ELISA) for the detection of tryptase levels. Preliminary results: Results are still being analysed but the preliminary optimisation experiments tested four different ELISA systems; two indirect assays and two capture ‹sandwich› assays. The results suggest that in both sandwich assay systems non-specific binding occurred which could not be easily overcome. The indirect assay systems both showed specific reactions, and the sensitivity achieved was greater with the monoclonal than the polyclonal antibody. Using these findings the indirect assay system was optimised to provide a standardised system for measuring tryptase. Initial trials using human tear samples displayed tryptase levels between 23.1 and 175.1 ng/ml; levels which fall within the anticipated range for patients with SAC. Further statistical work is needed to determine whether tryptase levels vary between the treatments 75.

Do intelligent heating controls out-smart ordinary users?

Nearly a third of UK gas and electricity is used in homes, of which 80% is for space heating and hot water provision. Rising consumer bills, concerns about climate change and the surge in personal digital technology use has provoked the development of intelligent domestic heating controls. Whilst the need for having suitable control of the home heating system is essential for reducing domestic energy use, these heating controls rely on appropriate user interaction to achieve a saving and it is unclear whether these ‘smart’ heating controls enhance the use of domestic heating or reduce energy demand. This paper describes qualitative research undertaken with a small sample of UK householders to understand how people use new heating controls installed in their homes and what the requirements are for improved smart heating control design. The paper identifies, against Nielsen’s usability heuristics, the divergence between the householder’s use, understanding and expectations of the heating system and the actual design of the system. Digital and smart heating control systems should be designed to maximise usability so that they can be effectively used for efficient heating control by all users. The research highlights the need for development of new systems to readdress the needs of users and redefine the system requirements.