Family-based associations in measures of psychological distress and quality of life in a cardiac screening clinic for inheritable cardiac diseases: a cross-sectional study

BACKGROUND: Family-based cardiac screening programmes for persons at risk for genetic cardiac diseases are now recommended. However, the psychological wellbeing and health related quality of life (QoL) of such screened patients is poorly understood, especially in younger patients. We sought to examine wellbeing and QoL in a representative group of adults aged 16 and over in a dedicated family cardiac screening clinic.

METHODS: Prospective survey of consecutive consenting patients attending a cardiac screening clinic, over a 12 month period. Data were collected using two health measurement tools: the Short Form 12 (version 2) and the Hospital Anxiety and Depression Scale (HADS), along with baseline demographic and screening visit-related data. The HADS and SF-12v.2 outcomes were compared by age group. Associations with a higher HADS score were examined using logistic regression, with multi-level modelling used to account for the family-based structure of the data.

RESULTS: There was a study response rate of 86.6%, with n=334 patients providing valid HADS data (valid response rate 79.5%), and data on n=316 retained for analysis. One-fifth of patients were aged under 25 (n=61). Younger patients were less likely than older to describe significant depression on their HADS scale (p<0.0001), although there were overall no difference between the prevalence of a significant HADS score between the younger and older age groups (18.0% vs 20.0%, p=0.73). Significant positive associates of a higher HADS score were having lower educational attainment, being single or separated, and being closely related to the family proband. Between-family variance in anxiety and depression scores was greater than within-family variance.

CONCLUSIONS: High levels of anxiety were seen amongst patients attending a family-based cardiac screening clinic.Younger patients also had high rates of clinically significant anxiety. Higher levels of anxiety and depression tends to run in families, and this has implications for family screening and intervention programmes.

Clinical trial designs for rare diseases: Studies developed and discussed by the International Rare Cancers Initiative

BACKGROUND: The past three decades have seen rapid improvements in the diagnosis and treatment of most cancers and the most important contributor has been research. Progress in rare cancers has been slower, not least because of the challenges of undertaking research.

SETTINGS: The International Rare Cancers Initiative (IRCI) is a partnership which aims to stimulate and facilitate the development of international clinical trials for patients with rare cancers. It is focused on interventional--usually randomized--clinical trials with the clear goal of improving outcomes for patients. The key challenges are organisational and methodological. A multi-disciplinary workshop to review the methods used in ICRI portfolio trials was held in Amsterdam in September 2013. Other as-yet unrealised methods were also discussed.

RESULTS: The IRCI trials are each presented to exemplify possible approaches to designing credible trials in rare cancers. Researchers may consider these for use in future trials and understand the choices made for each design.

INTERPRETATION: Trials can be designed using a wide array of possibilities. There is no 'one size fits all' solution. In order to make progress in the rare diseases, decisions to change practice will have to be based on less direct evidence from clinical trials than in more common diseases.

Interference cancellation for distributed wireless systems

O tema principal desta tese é o problema de cancelamento de interferência para sistemas multi-utilizador, com antenas distribuídas. Como tal, ao iniciar, uma visão geral das principais propriedades de um sistema de antenas distribuídas é apresentada. Esta descrição inclui o estudo analítico do impacto da ligação, dos utilizadores do sistema, a mais antenas distribuídas. Durante essa análise é demonstrado que a propriedade mais importante do sistema para obtenção do ganho máximo, através da ligação de mais antenas de transmissão, é a simetria espacial e que os utilizadores nas fronteiras das células são os mais bene ciados. Tais resultados são comprovados através de simulação. O problema de cancelamento de interferência multi-utilizador é considerado tanto para o caso unidimensional (i.e. sem codi cação) como para o multidimensional (i.e. com codi cação). Para o caso unidimensional um algoritmo de pré-codi cação não-linear é proposto e avaliado, tendo como objectivo a minimização da taxa de erro de bit. Tanto o caso de portadora única como o de multipla-portadora são abordados, bem como o cenário de antenas colocadas e distribuidas. É demonstrado que o esquema proposto pode ser visto como uma extensão do bem conhecido esquema de zeros forçados, cuja desempenho é provado ser um limite inferior para o esquema generalizado. O algoritmo é avaliado, para diferentes cenários, através de simulação, a qual indica desempenho perto do óptimo, com baixa complexidade. Para o caso multi-dimensional um esquema para efectuar "dirty paper coding" binário, tendo como base códigos de dupla camada é proposto. No desenvolvimento deste esquema, a compressão com perdas de informação, é considerada como um subproblema. Resultados de simulação indicam transmissão dedigna proxima do limite de Shannon.

Os arquivos das paróquias do município de Sintra: contributo para a sua reconstituição

Tese de mestrado, Ciências da Documentação e Informação (Arquivística), Universidade de Lisboa, Faculdade de Letras, 2012

A Student Composers' Recital, May 7, 1959 8:30pm

Concert program for A Student Composers' Recital, May 7, 1959

Nonlinear distortion evaluation of reconfigurable RF circuits in wireless communication systems

A compact highly linear microstrip dual - mode optically switchable filter and a reconfigurable power amplifier are presented. The key characteristics of the dual - mode switchable filter are investigated and described. A second order filter design procedure is outlined to facilitate the realisation of Butterworth and Chebyshev functions. The proposed filter was built and tested with an optical switch, which comprised of a silicon dice acti vated using near infrared light. The measured and simulated results are in good agreement. The measured insertion loss in the ON state was 3.0 dB the isolation in the OFF state was 45 dB at the centre frequency. An evaluation of filter distortion is presen ted for digitally modulated M - QAM and M - QAM OFDM singals.

Kid Lewis [Gershon Mendeloff, boxeur anglais] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57768

Brock Hockey Team (1981-82)

Back Row: Paul Jackson (Asst. Coach), Paul DeGagne (Manager), Angelo Pontello, Yvan Prevost, Greg Foy, Ken Murray, Steve Ashfield, Rick Berard, Andy MacMillan, Kelly Toppazzini, Carl Van Bolderen, John Dakin, Loran Prentice, Joe Kenny (Trainer), Ron Anderson (Coach) Front Row: Logan Trafford, Mark Warren, Pat Gallagher, Phil Powers, Daryl Clancy, Ted Sawicki, Gord Christie, John Hogg, Brian Onifrichuk, Doug Riopelle, Shawn Barry Absent: Paul Hanley, Brad MacMillan, Rico Schirru, Mike Quinn (Asst. Coach)

A comparison of cognitive processes and components of neurological maturation in 3-and-11 year-old children

The relationship between the child's cogni tive development and neurological maturation has been of theoretical interest for many year s. Due to diff iculties such as the lack of sophisticated techniques for measur ing neurolog ical changes and a paucity of normative data, few studies exist that have attempted to correlate the two factors. Recent theory on intellectual development has proposed that neurological maturation may be a factor in the increase of short-term memory storage space. Improved technology has allowed reliable recordings of neurolog ical maturation.. In an attempt to correlate cogni tive development and neurological maturation, this study tested 3-and II-year old children. Fine motor and gross motor short-term memory tests were used to index cogni tive development. Somatosensory evoked potentials elici ted by median nerve stimulation were used to measure the time required for the sensation to pass along the nerve to specific points on the somatosensory pathway. Times were recorded for N14, N20, and P22 interpeak latencies. Maturation of the central nervous system (brain and spinal cord) and the peripheral nervous system (outside the brain and spinal cord) was indi~ated by the recorded times. Signif icant developmental di fferences occurred between 3-and ll-year-olds in memory levels, per ipheral conduction velocity and central conduction times. Linear regression analyses showed that as age increased, memory levels increased and central conduction times decreased. Between the ll-year-old groups, there were no significant differences in central or peripheral nervous system maturation between subjects who achieved a 12 plus score on the digit span test of the WISC-R and those who scored 7 or lower on the same test. Levels achieved on the experimental gross and fine motor short-term memory tests differed significantly within the ll-year-old group.

A geochemical and paleoceanographic investigation using marine molluscs of the late Quaternary marine submergences Quebec, Ontario, British Columbia

Sedjrrlents deposited in the Late Quaternary marine sUbrnergences that follov'ted the deglaciation of Ontario} Quebec., and 6ritlst-1 Columbia often contaln an abundant nlarlne invertebrate macrofauna. The rnacrofauna~ dotYllnated by aragonitic pelecypods} is fully preserved In their original mineralogy and cherrlistry 8S deternl1ned by x-ray dlffractlon., scannlng electron tl-,lcroscoDY., trace and r1l1 nor elet11ent analyses and stable isotopes. Ttle trace elernent and stable isotope geochen-Ilstry of chernlcal1y unaltered aragorlitlc molluscs can be used to determine paleoter1-lperatures and paleosallnltles." HO\Never} corrections need to be tllade \fvtlen deterrTIlnlng oxygen-isotope paleotenlperi:ttures due to the lnfluence of isotopically 11gtlt glaciol rneltv-laters and reduced sal1nltles. Ttle eastern Laurentide Ice Sheet probably had an o:~ygen lS0tOP1C composition as low as -8e) 0/00 (Sr1[IW). In additl0fl} corrections need to be rnade to the carbonlsotope values, before salinity deterrnlnatlons are t11ade., due to the reJjuctlon of the terrestrial carbon bl0rnass during glac1al maxlrna. Using geochernlcal data frot11 537 marlne n-'8crolnvertebrates frorTI 72 localities in soutt-,easter Ontarl0 and southern Quebec, it tras been deterrnined that the Late Quaternary Char1lplaln Sea \N6S density stratified along salinity and temperatlJre gradients. The deep-\h/aters of tt-,e Charnplaln Sea tlad salinities that ranged frorn 31 to 36 ppt} and terrlperatures of 00 to 5°C. Conversely.. the st1alloy./-\f*later regirrle of ttle Ctlarnplaln Sea tlad sal1nltles that ranged fron-, 24 to 33 ppt} Y.tltt1 terrlperatures ranglng from 5° to 15°C. Tr,8 rrlajorl rnlnor1 and trace e1et1-,ent geochernlcal analysls of 155 marine lnvertebrates frorn 4 10C611t1es of tt-,e Late Quaternary Ft. Langley Forrnatlon and Capl1ano Sedlments;. souttl\Nestern Brltlsh Columblal suggest l t~lat the 'waters of the o-,arlne lnundation that fol1o....ved the retreating Cordl11eran Ice Sheet had sal1nltles ranglng frorn 32 to 3f. DPt.

Measuring curriculum integration in the junior grades: the design of an instrument

This study \Alas initiated in response to the Junior Division Review (1985) publ ished by the Ministry of Education for the Province of Ontario. Curriculum integration is an element used within the educational paradigm designed by the Ontario Ministry of Education. It is a term frequent1y verbal ized b>' educators in this province, but because of 1 imi ted resource support regarding this methodology, it was open to broad interpretation resulting in an extreme v ar i at i on i nit simp 1 eme n tat i on • I n de ed, the Min i s try intimated that it was not occurring to any significant degree across the province. The objective of this thes is was· to define integration in the junior classroom and de-:.ign a meas.ur·ement in-:.tr-ument which would in turn high 1 i gh t indicators of curriculum integration. The :.tudy made a prel iminary, field-based survey of educa tiona 1 professionals in order to generate a relevant description of integrated curr-iculum programm i ng as def i ned in the j un i or classroom. The description was a compilation of views expressed by a random selection of teachers, consultants, supervisory officers and principals. The survey revea 1 ed a much more comprehens i ve vi et·<,l of the attributes of integrated programming than tradition would dictate and resulted in a functional definition tha t was broader than past prac t ices. Based on the information generated by this survey, an instrument ou t 1 in i ng program cr iter i a of was devised. an integrated junior cla~·sroom Th i s measuremen t i nstrumen t , designed for all levels of educators, was named uThe Han~.son I nstrumen t for the Measuremen t of Program Integrat ion in the Jun i or Cl assroom". It refl ected five categories intrinsic to the me thodol ogy of integration: Teacher Behaviour, Student Behaviour, Classroom Layout, Cl as~·r oom Environment and Progr amm i ng. Each category and the items therein were successfully tested in val idi ty and rel iabi 1 i ty checKs. Interestingly, the individual class was found to be the major variable programming in in the measuremen t the j un i or d i vis i on • of The integrated instrument demonstrated potential not onl)' a~· an initial measure of the degree of integrated curriculum, but as a guide to strategies to implement such a methodology.

Molecular mechanics calculations of tin-bis (triphenylphosphine oxide) complexes

The capability of molecular mechanics for modeling the wide distribution of bond angles and bond lengths characteristic of coordination complexes was investigatecl. This was the preliminary step for future modeling of solvent extraction. Several tin-phosphine oxide COrnI)le:){es were selected as the test groUl) for t.he d,esired range of geometry they eX!libi ted as \-vell as the ligands they cOD.tained r Wllich were c\f interest in connection with solvation. A variety of adjustments were made to Allinger's M:M2 force·-field ill order to inl.prove its performance in the treatment of these systems. A set of u,nique force constants was introduced for' those terms representing the metal ligand bond lengths, bond angles, and, torsion angles. These were significantly smaller than trad.itionallY used. with organic compounds. The ~1orse poteIlt.ial energ'Y function was incorporated for the M-X l')ond lE~ngths and the cosine harmonic potential erlerg-y function was invoked for the MOP bond angle. These functions were found to accomodate the wide distribution of observed values better than the traditional harmonic approximations~ Crystal packing influences on the MOP angle were explored thr"ollgh ttle inclusion of the isolated molecule withil1 a shell cc)ntaini11g tl1e nearest neigl1'bors duri.rlg energy rninimization experiments~ This was found to further improve the fit of the MOP angle.

Palladium and platinum complexes of vitamin Bâ

Palladium and platinum complexes of pyridoxamine, pyridoxine and pyridoxal have been prepared. The structures of the complexes PtCI2PM.H20, trans-PdC12 (PN)2 and [PLH+ ]2[PtC16] 2- ,H20 have been determined by use of single crystal x-ray studies. The compounds PdC12PH, trans-PdC12 (PN) 2 , cis-PdCI2 (PN)2 and cis PdC12 (PL)2 were also studied by use of carbon-13 nmr spectroscopy. All the complexes have also been characterised by use of infrared spectral studies. In the complexes, PtCI2PM.H20 and PdC12PM, the ligand pyridoxamine is chela ted to the metal through the aminomethyl nitrogen and the phenolate oxygen atoms whereas in the complexes, trans-PdCI2 (PN)2' cis-PdCI2 (PN)2 and cis-PdC12 (PL)2 the vitamin B6 ligands are coordinated to the metal through the pyridine ring nitrogen. The compounds [PLH+ ]2[PtCI6] 2- .H20 and [PMH2] 2+ [PdCI4] 2- .H20have no direct metal-ligand bonding, In all the complexes, the metal maintains a square planar coordination except in [PLH +] 2[PtCI6] 2- ,H20 where the metal is octahedrally coordinated. PH pyridoxamine [PMH ] 2+ = diprotonated pyridoxamine 2 PN = pyridoxine PL pyridoxal PLH+ protonated pyridoxal

Sinister creativity: a phenomenological exploration of some of the experiences and perceptions of six lefthanded visual artists

Six lefthanded artist-educators were interviewed to attempt to discover any patterns t6 their perceptions and experiences. Artists have their own culture and priorities. According to the literature, lefthanded people appear more likely to suffer from dyslexia, allergies, asthma and other auto-immune diseases as well as machinery and equipment injuries. Patterns emerging suggested that lefthanded people indeed suffer more from dyslexia. More startling was the distinct possibility that many artists have traumatic childhood histories. This would commonly include negative school experiences, and for a significant number sexual assault, perceived or actual abandonment by parents, and/or consistently low selfesteem. The researcher discovered possible reasons why creative people frequently have problems at school, why they tend to be rebellious and anti-establishment oriented, how many of them perceive societal rules, and why they are more likely to be lefthanded. These characteristics all have significant implications for art school administrators.