The experience of cancer cachexia: A qualitative study of advanced cancer patients and their family members

Background
Cachexia in advanced malignancy is a debilitating syndrome which contributes to approximately two million deaths worldwide annually. In spite of advances in understanding the biomedical aspects of cancer cachexia, little attention has been paid to exploring its holistic impact on patients and those who care for them.

Objective
The aim of this paper is to describe the lived experience of cachexia from the perspective of patients with cancer and their family members.

Design
An interpretative phenomenological approach was employed.

Setting and participants
A purposive sampling strategy recruited 15 patients and 12 family members from the Regional Cancer Centre in Northern Ireland.

Method
Each participant was interviewed during 2004/2005 using an unstructured interview. All interviews were recorded and transcribed verbatim. Analysis combined a two stage approach using thematic and interpretative phenomenological analysis.

Results
Analysis generated six superordinate themes that reflected the complex dynamics of the cachexia experience. Themes were: physiological changes in appetite; visuality of cachexia; weight loss interpreted as a bad sign; response from health care professionals; conflict over food; and coping responses.

Conclusions
Findings confirmed that cancer cachexia has far reaching implications for patients and their families, extending beyond physical problems into psychological, social and emotional issues. This insight is a critical first step in the development of more responsive care for these clients.

New members of the chiral pool:  -hydroxypiperidine carboxylates from bakers' yeast reductions of the corresponding keto-esters.

. Knight, David W.; Lewis, Neil; Share, Andrew C.; Haigh, David. Chem. Dept., Univ. of Nottingham, Nottingham, UK. Tetrahedron: Asymmetry (1993), 4(4), 625-8. CODEN: TASYE3 ISSN: 0957-4166. Journal written in English. CAN 120:54423 AN 1994:54423 CAPLUS (Copyright (C) 2009 ACS on SciFinder (R)) Abstract Redn. of the keto-piperidinecarboxylates I and II with fermenting bakers' yeast produced the corresponding hydroxy-esters III and IV in good yields with >99% diastereomeric excess and >93% enantiomeric excess in both cases.

Speciation in Red Algae: Members of the Ceramiales as Model Organisms

Red algae (Rhodophyta) are an ancient group with unusual morphological, biochemical, and life-history features including a complete absence of flagella. Although the red algae present many opportunities for studying speciation, this has rarely been explicitly addressed. Here, we examine an aspect of paternal gene flow by determining fertilization success of female Neosiphonia harveyi (Ceramiales), which retains a morphological record of all successful and unsuccessful female gametes. High fertilization rates were observed except when there were no males at all within the tidepool, or in a submerged marina environment. Small numbers of reproductive males were able to saturate fertilization rates, suggesting that limited availability of sperm may be less significant in red algae than previously thought. In another member of the Ceramiales, Antithamnion, relatively large chromosomes permit karyological identification of polyploids. The Western Pacific species Antithamnion sparsum is closely related to the diploid species Antithamnion defectum, known only from the Eastern Pacific, and appears to have evolved from it. Molecular evidence suggests that A. sparsum is an autopolyploid, and that the European species known as Antithamnion densum is divergent from the A. sparsum/defectum complex.

Stiffness prediction for bolted moment-connections between cold-formed steel members

The authors have recently described a cold-formed steel portal framing system in which simple bolted moment-connections, formed through brackets, were used for the eaves and apex joints. Such connections, however, cannot be considered as rigid because of localised in-plane elongation of the bolt-holes caused by bearing against the bolt-shanks. To therefore predict the initial stiffness of such connections, it is necessary to know the initial bolt-hole elongation stiffness k(b). In this paper, a finite element-solid idealisation of a bolted lap joint in shear will be described that can be used to determine k(b); the results obtained are validated against experimental data. A beam idealisation of a cold-formed steel bolted moment-connection is then described, in which spring elements are used to idealise the rotational flexibility of the bolt-groups resulting from bolt-hole elongation: Using the value of k(b) in the beam idealisation, the deflections predicted are shown to be similar to those measured experimentally in laboratory tests conducted on the apex joint of a cold-formed steel portal frame. (C) 2003 Elsevier Ltd. All rights reserved.

Ultimate strength of bolted moment-connections between cold-formed steel members

The behaviour and design of bolted moment-connections between cold-formed steel members, formed by using brackets bolted to the webs of the section, is considered. The particular problem of the moment-capacity of such joints being lower than that of the cold-formed steel sections being connected because of web buckling, caused by the concentration of load transfer from the bolts, is addressed. In this paper, a combination of laboratory tests and finite element analyses is used to investigate this mode of failure. It is demonstrated that there is good agreement between the measured ultimate moment-capacity and that predicted by using the finite element method. A parametric study conducted using the finite element model shows that the moment-capacity of a practical size joint can be up to 20% lower than that of the cold-formed steel sections being connected. Web buckling so-caused must therefore be considered in the design of such connections. (C) 2003 Elsevier Ltd. All rights reserved.

Effects of elevated temperatures on bolted moment-connections between cold-formed steel members

Experimental investigations at ambient temperature into the behaviour of bolted moment-connections between cold-formed steel members have previously been described. Full-scale joint tests have demonstrated that the channel-sections being connected are susceptible to premature failure, the result of web buckling caused by the concentration of load transfer from the bolts. The results of tests on bolted lap joints have been used to propose design recommendations for the shear strength in bearing of the bolt-hole. For both types of test, the results of non-linear elasto-plastic finite element analyses have been shown to have good agreement. No consideration, however, has been given to the behaviour of such connections at elevated temperatures. This paper describes non-linear elasto-plastic finite element parametric studies into the effects of elevated temperatures on bolted moment-connections between cold-formed steel members. Two issues at elevated temperatures are investigated: