Life events and social support among patients with major depressive disorder

The study is part of a research project of 269 psychiatric patients with major depression, Vantaa Depression Study, in the Department of Mental Health and Alcohol Research of the National Public Health Institute and the Department of Psychiatry of the Peijas Medical Care District. The aim was to study at the onset of MDE psychosocial differences in subgroups of patients and clustering of events into time before depression and its prodromal phase, to study whether more severe life events and less social support predict poorer outcome in all patients, but most among those currently in partial remission, whether social support declines as a consequence of time spent in MDE, is sensitive to improvement, and whether social support is influenced by neuroticism and extraversion. After screening, a semistructured interview (SCAN, version 2.0) was used for the presence of DSM-IV MDE, and other psychiatric diagnoses. Life events and social support were studied with semistructured methods (IRLE, Paykel 1983; IMSR, Brugha et al. 1987), perceived social support and neuroticism/extraversion with questionnaires (PSSS-R, Blumenthal et al. 1987; EPI, Eysenck and Eysenck 1964) at baseline, 6 and 18 months. At the onset of depression life events were common. No major differences between subgroups of patients were found; the younger had more events, whereas those with comorbid alcoholism and personality disorders perceived less support. Although events were distributed evenly between the time before depression, the prodromal phase and the index MDE, two thirds of the patients attributed their depression to some life event. Adversities and poor perceived support influenced the outcome of all psychiatric patients, most in the subgroup of full remission. In the partial remission group, the impact of severe events and in the MDE, perceived support was important. Low objective and subjective support were predicted by longer time spent in MDE. Along with improvement subjective support improved. Neuroticism and extraversion were associated with the size of social network and perceived support and predicted change of perceived support. In conclusion, adversities were common in all phases of depression. They may thus have many roles; before depression they may precipitate it, in the prodromal phase worsen symptoms, and during the MDE, the outcome of depression. Patients often attributed their depression to a life event. Psychosocial subgroup differences were quite small. Perceived support predicted the outcome of depression, and time spent in MDE objective and subjective support. Neuroticism and extraversion may modify the level and change particularly in perceived support, thereby indirectly effecting vulnerability to depression.

Design support for turbomachinery

From the steam turbines which provide most of our electricity to the jet engines which have shrunk our World, turbomachines undoubtedly play a major role in life today. Competition in the turbomachinery industry is fiercely strong [Wisler, 1998], hence good aerodynamic design is vital. However, with efficiency levels already close to their theoretical maxima, companies are increasingly looking to reduce costs and increase reliability through improved design practice. Computational Fluid Dynamics (CFD) can make a strong contribution to assisting this process as it has the potential to increase performance while reducing cost. The situation is, however, complicated by an ever decreasing number of engineers with sufficient design experience to reap the full benefits offered by CFD. With the large risks involved, novice designers of today are increasingly confined to refining old designs rather than gaining experience, like their forebears, through 'clean sheet' exercises. Hence it is desirable to capture the knowledge and experience of older designers, before it is lost, to assist the engineers of tomorrow. It is therefore the aim of this project to produce a design support tool which will not only store the appropriate CFD codes, but also provide a dynamic signpost (based on elicited knowledge and experience) to advise the engineer in their use. The signposting methodology developed for the aerospace industry [Clarkson and Hamilton, 1997] will provide the basic framework for the tool. This paper reviews current turbomachinery design practice (including an examination of the relevant CFD) in order to establish the important issues which a support tool must address. Current design support methodologies and their propriety are then reviewed, followed by a detailed description of the signposting concept. It then sets out a clear statement of the objectives for the research and the methods proposed to meet them. The paper concludes with a timetable of the work.

Specification of optimum holistic building environmental and energy performance information to support informed decision making

Political drivers such as the Kyoto protocol, the EU Energy Performance of Buildings Directive and the Energy end use and Services Directive have been implemented in response to an identified need for a reduction in human related CO2 emissions. Buildings account for a significant portion of global CO2 emissions, approximately 25-30%, and it is widely acknowledged by industry and research organisations that they operate inefficiently. In parallel, unsatisfactory indoor environmental conditions have proven to negatively impact occupant productivity. Legislative drivers and client education are seen as the key motivating factors for an improvement in the holistic environmental and energy performance of a building. A symbiotic relationship exists between building indoor environmental conditions and building energy consumption. However traditional Building Management Systems and Energy Management Systems treat these separately. Conventional performance analysis compares building energy consumption with a previously recorded value or with the consumption of a similar building and does not recognise the fact that all buildings are unique. Therefore what is required is a new framework which incorporates performance comparison against a theoretical building specific ideal benchmark. Traditionally Energy Managers, who work at the operational level of organisations with respect to building performance, do not have access to ideal performance benchmark information and as a result cannot optimally operate buildings. This thesis systematically defines Holistic Environmental and Energy Management and specifies the Scenario Modelling Technique which in turn uses an ideal performance benchmark. The holistic technique uses quantified expressions of building performance and by doing so enables the profiled Energy Manager to visualise his actions and the downstream consequences of his actions in the context of overall building operation. The Ideal Building Framework facilitates the use of this technique by acting as a Building Life Cycle (BLC) data repository through which ideal building performance benchmarks are systematically structured and stored in parallel with actual performance data. The Ideal Building Framework utilises transformed data in the form of the Ideal Set of Performance Objectives and Metrics which are capable of defining the performance of any building at any stage of the BLC. It is proposed that the union of Scenario Models for an individual building would result in a building specific Combination of Performance Metrics which would in turn be stored in the BLC data repository. The Ideal Data Set underpins the Ideal Set of Performance Objectives and Metrics and is the set of measurements required to monitor the performance of the Ideal Building. A Model View describes the unique building specific data relevant to a particular project stakeholder. The energy management data and information exchange requirements that underlie a Model View implementation are detailed and incorporate traditional and proposed energy management. This thesis also specifies the Model View Methodology which complements the Ideal Building Framework. The developed Model View and Rule Set methodology process utilises stakeholder specific rule sets to define stakeholder pertinent environmental and energy performance data. This generic process further enables each stakeholder to define the resolution of data desired. For example, basic, intermediate or detailed. The Model View methodology is applicable for all project stakeholders, each requiring its own customised rule set. Two rule sets are defined in detail, the Energy Manager rule set and the LEED Accreditor rule set. This particular measurement generation process accompanied by defined View would filter and expedite data access for all stakeholders involved in building performance. Information presentation is critical for effective use of the data provided by the Ideal Building Framework and the Energy Management View definition. The specifications for a customised Information Delivery Tool account for the established profile of Energy Managers and best practice user interface design. Components of the developed tool could also be used by Facility Managers working at the tactical and strategic levels of organisations. Informed decision making is made possible through specified decision assistance processes which incorporate the Scenario Modelling and Benchmarking techniques, the Ideal Building Framework, the Energy Manager Model View, the Information Delivery Tool and the established profile of Energy Managers. The Model View and Rule Set Methodology is effectively demonstrated on an appropriate mixed use existing ‘green’ building, the Environmental Research Institute at University College Cork, using the Energy Management and LEED rule sets. Informed Decision Making is also demonstrated using a prototype scenario for the demonstration building.

Life Around the Turbines

Life around the Turbines is an outreach project developed by the Marine Biological Association of the UK (MBA) funded by COWRIE (Collaborative Offshore Wind Research into the Environment). The project was designed to promote the need for renewable energy, raise awareness of marine biodiversity and generate discussions about offshore wind farms particularly with school children around Great Britain. The project has run from 2008 – 2014 and has involved workshops with schools all around Great Britain; production of online resources and a series of training events and tools for marine educators. All of the resources and workshops were developed to correlate with the national curricula for England, Scotland and Wales and cover a range of topics including science, citizenship and technology. Combining charismatic marine wildlife with technology and interactive, hands-on workshop activities has proved a successful and popular combination, received well by students and teachers. We present the methods of engagement used and some of the information received through a basic activity evaluation process. We will also share information about how conference participants can obtain and utilise free resources to support their own outreach and teaching at www.mba.ac.uk/education.

Providing psychological support for adults living with cancer. End of Life Care

http://endoflifejournal.stchristophers.org.uk/article/providing-psychological-support-for-adults-living-with-cancer

Reconsidering Resource Rights: The Case for a Basic Right to the Benefits of Life-Sustaining Ecosystem Services

In the presence of anthropogenic climate change, gross environmental degradation, and mass abject poverty, many political theorists currently debate issues such as people's right to water, the right to food, and the distribution of rights to natural resources more generally. However, thus far many theorists either focus (somewhat arbitrarily) only on one particular resource (e.g. water) or they treat all natural resources alike, meaning that many relevant distinctions within the group of natural resources are overlooked. Hence, the paper will start with an analysis of the various forms which natural resources can take and how this might influence one's conception of resource rights. In so doing, the paper argues that we have to carefully distinguish between the actual physical resources people might control and how we distribute these, and the life-sustaining benefits each and every person draws from sustainable and functioning ecosystems. Based on this distinction, the paper will argue for a right to the benefits of life-sustaining ecosystem services as a universal basic right every person has. Further distributive claims with respect to particular physical resources would thus be limited by the requirements of such a basic right.

After the Liverpool Care Pathway clear guidance and support on end-of-life care is needed

Commentary on: Ramasamy Venkatasalu M, Whiting D, Cairnduff K. Life after the Liverpool Care Pathway (LCP): a qualitative study of critical care practitioners delivering end-of-life care. J Adv Nurs 2015;71:2108–18.

Location-routing problems of semi-obnoxious facilities: approaches and decision support

A presente tese resulta de um trabalho de investigação cujo objectivo se centrou no problema de localização-distribuição (PLD) que pretende abordar, de forma integrada, duas actividades logísticas intimamente relacionadas: a localização de equipamentos e a distribuição de produtos. O PLD, nomeadamente a sua modelação matemática, tem sido estudado na literatura, dando origem a diversas aproximações que resultam de diferentes cenários reais. Importa portanto agrupar as diferentes variantes por forma a facilitar e potenciar a sua investigação. Após fazer uma revisão e propor uma taxonomia dos modelos de localização-distribuição, este trabalho foca-se na resolução de alguns modelos considerados como mais representativos. É feita assim a análise de dois dos PLDs mais básicos (os problema capacitados com procura nos nós e nos arcos), sendo apresentadas, para ambos, propostas de resolução. Posteriormente, é abordada a localização-distribuição de serviços semiobnóxios. Este tipo de serviços, ainda que seja necessário e indispensável para o público em geral, dada a sua natureza, exerce um efeito desagradável sobre as comunidades contíguas. Assim, aos critérios tipicamente utilizados na tomada de decisão sobre a localização destes serviços (habitualmente a minimização de custo) é necessário adicionar preocupações que reflectem a manutenção da qualidade de vida das regiões que sofrem o impacto do resultado da referida decisão. A abordagem da localização-distribuição de serviços semiobnóxios requer portanto uma análise multi-objectivo. Esta análise pode ser feita com recurso a dois métodos distintos: não interactivos e interactivos. Ambos são abordados nesta tese, com novas propostas, sendo o método interactivo proposto aplicável a outros problemas de programação inteira mista multi-objectivo. Por último, é desenvolvida uma ferramenta de apoio à decisão para os problemas abordados nesta tese, sendo apresentada a metodologia adoptada e as suas principais funcionalidades. A ferramenta desenvolvida tem grandes preocupações com a interface de utilizador, visto ser direccionada para decisores que tipicamente não têm conhecimentos sobre os modelos matemáticos subjacentes a este tipo de problemas.

Curriculum and beyond: Mathematics support for first year life science students

The move into higher education is a real challenge for students from all educational backgrounds, with the adaptation to a new curriculum and style of learning and teaching posing a daunting task. A series of exercises were planned to boost the impact of the mathematics support for level four students and was focussed around a core module for all students. The intention was to develop greater confidence in tackling mathematical problems in all levels of ability and to provide more structured transition period in the first semester of level 4. Over a two-year period the teaching team for Biochemistry and Molecular Biology provided a series of structured formative tutorials and “interactive” online problems. Video solutions to all formative problems were made available, in order that students were able to engage with the problems at any time and were not disadvantaged if they could not attend. The formative problems were specifically set to dovetail into a practical report in which the mathematical skills developed were specifically assessed. Students overwhelmingly agreed that the structured formative activities had broadened their understanding of the subject and that more such activities would help. Furthermore, it is interesting to note that the package of changes undertaken resulted in a significant increase in the overall module mark over the two years of development.

A Clinical Support System Based on Quality of Life Estimation

Quality of life is a concept influenced by social, economic, psychological, spiritual or medical state factors. More specifically, the perceived quality of an individual's daily life is an assessment of their well-being or lack of it. In this context, information technologies may help on the management of services for healthcare of chronic patients such as estimating the patient quality of life and helping the medical staff to take appropriate measures to increase each patient quality of life. This paper describes a Quality of Life estimation system developed using information technologies and the application of data mining algorithms to access the information of clinical data of patients with cancer from Otorhinolaryngology and Head and Neck services of an oncology institution. The system was evaluated with a sample composed of 3013 patients. The results achieved show that there are variables that may be significant predictors for the Quality of Life of the patient: years of smoking (p value 0.049) and size of the tumor (p value < 0.001). In order to assign the variables to the classification of the quality of life the best accuracy was obtained by applying the John Platt's sequential minimal optimization algorithm for training a support vector classifier. In conclusion data mining techniques allow having access to patients additional information helping the physicians to be able to know the quality of life and produce a well-informed clinical decision.

Practice multiple-choice papers suitable for : key skills level 1 communication, level 1 adult literacy (basic skills), and ESOL skills for life level 1 reading.

Este recurso puede ser utilizado tanto por los tutores como por los estudiantes que siguen las habilidades básicas, alumnos adultos de alfabetización en la evaluación final en el nivel 1 y los estudiantes de ESOL (English for speakers of other languages) en lectura. Contiene 12 cuestionarios, cada uno con 40 preguntas de opción múltiple para evaluar la capacidad del candidato para identificar los puntos e ideas principales de los escritos, entender el significado de los documentos y su estilo de escritura, interpretar la información de tablas, gráficos y mapas, y reconocer la ortografía, la gramática y la puntuación. También, incluye las respuestas y las hojas de evaluación para fotocopiar.

Practice multiple-choice papers suitable for : key skills level 2 communication, level 2 adult literacy (basic skills), and ESOL skills for life level 2 reading.

Este recurso puede ser utilizado tanto por los tutores como por los estudiantes que siguen las habilidades básicas, alumnos adultos de alfabetización en la evaluación final en el nivel 2 y los estudiantes de ESOL (English for speakers of other languages) en lectura. Contiene 12 cuestionarios, cada uno con 40 preguntas de opción múltiple para evaluar la capacidad del candidato para identificar los puntos e ideas principales de los escritos, entender el significado de los documentos y su estilo de escritura, interpretar la información de tablas, gráficos y mapas, y reconocer la ortografía, la gramática y la puntuación. También, incluye las respuestas y las hojas de evaluación para fotocopiar.