An exploration into the palliative and end-of-life experiences of carers of people with Parkinson's disease

Although most people with Parkinson's disease are cared for in the community, little is known about family members' lived experiences of palliative or end-of-life care. The aim of this study was to explore former carers' lived experiences of palliative and end-of-life care. In total, 15 former family caregivers of patients who had died with Parkinson's disease were interviewed using a semi-structured topic list. Findings indicated that some palliative and end-of-life care needs had not been fully addressed. Lack of communication, knowledge and coordination of services resulted in many people caring for someone with Parkinson's disease not accessing specialist palliative care services. Participants also reflected upon the physical and psychological impact of caring in the advanced stage of Parkinson's. A multi-disciplinary team-based approach was advocated by participants. These findings provide important insights into the experience of caregiving to patients with Parkinson's disease in the home at the end-of-life stage. According to palliative care standards, patients and their carers are the unit of care; in reality, however, this standard is not being met.

An extended framework for evidential reasoning systems

Based on the Dempster-Shafer (D-S) theory of evidence and G. Yen's (1989), extension of the theory, the authors propose approaches to representing heuristic knowledge by evidential mapping and pooling the mass distribution in a complex frame by partitioning that frame using Shafter's partition technique. The authors have generalized Yen's model from Bayesian probability theory to the D-S theory of evidence. Based on such a generalized model, an extended framework for evidential reasoning systems is briefly specified in which a semi-graph method is used to describe the heuristic knowledge. The advantage of such a method is that it can avoid the complexity of graphs without losing the explicitness of graphs. The extended framework can be widely used to build expert systems

Molecular Cloning of a Novel Tryptophyllin Peptide from the Skin of the Orange-Legged Monkey Frog, Phyllomedusa hypochondrialis

Tryptophyllins are a group of small (4–14 amino acids), heterogenous peptides, mostly from the skins of hylid frogs from the genera, Phyllomedusa and Litoria. To date, more than forty TPHs have been discovered in species from these two genera. Here, we describe the identification of a novel tryptophyllin type 3 peptide, PhT-3, from the extracts of skin of the orange-legged monkey frog, Phyllomedusa hypochondrialis, and molecular cloning of its precursor-encoding cDNA from a cDNA library constructed from the same skin sample. Full primary structural characterization was achieved using a combination of direct Edman degradation, mass spectrometry and deduction from cloned skin-derived cDNA. The open-reading frame of the precursor cDNA was found to consist of 63 amino acid residues. The mature peptide arising from this precursor contains a post-translationally modified N-terminal pyroglutamate (pGlu) residue, formed from acid-mediated cyclization of an N-terminal Gln (Q) residue, and with the structure: pGlu-Asp-Lys-Pro-Phe-Trp-Pro-Pro-Pro-Ile-Tyr-Pro-Met. Pharmacological assessment of a synthetic replicate of this peptide on phenylephrine preconstricted rat tail artery segments, revealed a reduction in relaxation induced by bradykinin. PhT-3 was also found to mediate antiproliferative effects on human prostate cancer cell lines.

Combining multi-scale geophysical techniques for robust hydro-structural characterisation in catchments underlain by hard rock in post-glacial regions

Accurate conceptual models of groundwater systems are essential for correct interpretation of monitoring data in catchment studies. In surface-water dominated hard rock regions, modern ground and surface water monitoring programmes often have very high resolution chemical, meteorological and hydrological observations but lack an equivalent emphasis on the subsurface environment, the properties of which exert a strong control on flow pathways and interactions with surface waters. The reasons for this disparity are the complexity of the system and the difficulty in accurately characterising the subsurface, except locally at outcrops or in boreholes. This is particularly the case in maritime north-western Europe, where a legacy of glacial activity, combined with large areas underlain by heterogeneous igneous and metamorphic bedrock, make the structure and weathering of bedrock difficult to map or model. Traditional approaches which seek to extrapolate information from borehole to field-scale are of limited application in these environments due to the high degree of spatial heterogeneity. Here we apply an integrative and multi-scale approach, optimising and combining standard geophysical techniques to generate a three-dimensional geological conceptual model of the subsurface in a catchment in NE Ireland. Available airborne LiDAR, electromagnetic and magnetic data sets were analysed for the region. At field-scale surface geophysical methods, including electrical resistivity tomography, seismic refraction, ground penetrating radar and magnetic surveys, were used and combined with field mapping of outcrops and borehole testing. The study demonstrates how combined interpretation of multiple methods at a range of scales produces robust three-dimensional conceptual models and a stronger basis for interpreting groundwater and surface water monitoring data.

Genetic pleiotropy between multiple sclerosis and schizophrenia but not bipolar disorder: differential involvement of immune-related gene loci

Converging evidence implicates immune abnormalities in schizophrenia (SCZ), and recent genome-wide association studies (GWAS) have identified immune-related single-nucleotide polymorphisms (SNPs) associated with SCZ. Using the conditional false discovery rate (FDR) approach, we evaluated pleiotropy in SNPs associated with SCZ (n=21 856) and multiple sclerosis (MS) (n=43 879), an inflammatory, demyelinating disease of the central nervous system. Because SCZ and bipolar disorder (BD) show substantial clinical and genetic overlap, we also investigated pleiotropy between BD (n=16 731) and MS. We found significant genetic overlap between SCZ and MS and identified 21 independent loci associated with SCZ, conditioned on association with MS. This enrichment was driven by the major histocompatibility complex (MHC). Importantly, we detected the involvement of the same human leukocyte antigen (HLA) alleles in both SCZ and MS, but with an opposite directionality of effect of associated HLA alleles (that is, MS risk alleles were associated with decreased SCZ risk). In contrast, we found no genetic overlap between BD and MS. Considered together, our findings demonstrate genetic pleiotropy between SCZ and MS and suggest that the MHC signals may differentiate SCZ from BD susceptibility.Molecular Psychiatry advance online publication, 28 January 2014; doi:10.1038/mp.2013.195.

Re-Visiting Sylvia Townsend Warner

Sylvia Townsend Warner was born in 1893 in Harrow and died in Dorset in 1978. Her writing career was both productive and diverse, spanning poems, short stories, novels, music reviews, a biography, translations of Proust, and a guide to Somerset. But this list, impressive as it is, does not do justice to the idiosyncrasy and heterogeneity of her work. While she is well known mostly for the seven novels she published, those works are all radically different in style and content. Indeed, Townsend Warner's singularity has, it could be argued, made it difficult to place her in the various fields and sub-fields of 20th-century literary studies. She shares as many similarities as differences with the high modernists who dominated the literary landscape of the interwar period. Likewise she fits, yet also resists, the more recent formulations of intermodernist and middlebrow scholarship that have attempted to interrogate and expand the horizons of mid-20th century literature.

Early childhood neurodevelopment after intrauterine growth restriction: a systematic review

BACKGROUND AND OBJECTIVE: Children who experienced intrauterine growth restriction (IUGR) may be at increased risk for adverse developmental outcomes in early childhood. The objective of this study was to carry out a systematic review of neurodevelopmental outcomes from 6 months to 3 years after IUGR.

METHODS: PubMed, Embase, PsycINFO, Maternity and Infant Care, and CINAHL databases were searched by using the search terms intrauterine, fetal, growth restriction, child development, neurodevelopment, early childhood, cognitive, motor, speech, language. Studies were eligible for inclusion if participants met specified criteria for growth restriction, follow-up was conducted within 6 months to 3 years, methods were adequately described, non-IUGR comparison groups were included, and full English text of the article was available. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-documented quality-appraisal guidelines.

RESULTS: Of 731 studies reviewed, 16 were included. Poorer neurodevelopmental outcomes after IUGR were described in 11. Ten found motor, 8 cognitive, and 7 language delays. Other delays included social development, attention, and adaptive behavior. Only 8 included abnormal Doppler parameters in their definitions of IUGR.

CONCLUSIONS: Evidence suggests that children are at risk for poorer neurodevelopmental outcomes following IUGR from 6 months to 3 years of age. The heterogeneity of primary outcomes, assessment measures, adjustment for confounding variables, and definitions of IUGR limits synthesis and interpretation. Sample sizes in most studies were small, and some examined preterm IUGR children without including term IUGR or AGA comparison groups, limiting the value of extant studies.

Rui Morais, Miguel Bandeira, Eliana Manuel Pinho, “Itineraria Sacra. Bracara Augusta Fidelis et Ancient

Recensão do livro "Itineraria Sacra. Bracara Augusta Fidelis et Ancient

Loss of Aggressiveness of Phytophthora cinnamomi (Beta-Cinnamomin Silenced Strain) in the Infection of Castanea sativa

Several forest species are severely affected by Phytophthora cinnamomi. The contribution of this oomycete to forest decline and dieback has been broadly reported. In particular, it is consensual that it is the causal agent of ink disease in Castanea sativa. It has been associated with the severe decline of Quercus species, namely the Q. suber and Q. ilex dieback in Portugal and Spain, and has been responsible for the infection of numerous native species and crops. This pathogen persists in the soil or on plant material in the form of chlamydospores allowing the infection of living root tissues when environmental conditions are favorable. © Microscopy Society of America 2012.

Community empowerment or a strategy of containment? Evaluating neighbourhood governance in the city of Westminster

The longstanding emphasis on the neighbourhood as a scale for intervention and action has given rise to a variety of forms of governance with a number of different rationales. The predominant rationales about the purpose of neighbourhood governance are encapsulated in a fourfold typology developed by Lowndes and Sullivan (2008). This article sets out to test this approach by drawing on an evaluation of neighbourhood initiatives in the City of Westminster which were delivered through a third sector organisation, the Paddington Development Trust. ‘Insider’ perspectives gathered at city and neighbourhood levels regarding the infrastructure for neighbourhood management are discussed and evaluated in the light of these rationales. The conclusions, while broadly reflecting Lowndes and Sullivan and a follow-up study of Manchester, suggest that in Westminster the civic and economic rationales tend to predominate. However, the Westminster approach is contingent on the prevailing ethos and funding regimes at central and local levels and remains relatively detached from mainstream services. While community empowerment is an important part of the policy rhetoric, it is argued that in practice a ‘strategy of containment’ operates whereby residents in the neighbourhoods have relatively little control over targets and resources and that new governance mechanisms can be relatively easily de-coupled when required. In retrospect, co-production might have been a more effective model for neighbourhood governance, not least given its fit with policy direction.

Diagnóstico ambiental de uma queijaria e proposta de melhorias

O presente trabalho tem como objectivo o diagnóstico ambiental da empresa Lacticinios do Paiva, S.A, a avaliação da água do processo e da ETARI e o estudo da fermentação do soro de queijo com o intuito de produção de bioetanol. No diagnóstico ambiental da empresa, observou-se que 18.227.731 litros de leite usados anualmente geram 5.031 ton/ano de queijo, 7.204 ton/ano de soro de queijo, 74.201 m3/ano de efluente liquido, 14 ton/ano de plástico e 20 ton/ano de cartão. Os principais problemas com necessidade de optimização são a recuperação de água das lavagens, avaliação da produção de biogás no digestor anaeróbio, recuperação do volume de leite que é desperdiçado na produção de queijo fresco de longa duração, avaliação da eficiência energética da empresa, valorização das natas e do soro de queijo. Decidiu-se neste trabalho avaliar a possibilidade de reciclagem das águas de lavagem, avaliar o funcionamento da ETARI face à legislação existente e estudar a possibilidade de valorização do soro de queijo. Na avaliação das águas de processo das lavagens para posterior reciclagem, verifica-se que relativamente ao pH e aos sólidos suspensos não existe problema, podendo encarar-se a hipótese de reciclagem directa. No entanto, no que respeita à carga orgânica das águas de lavagem do sistema de ultrafiltração do queijo fresco de longa duração, constata-se que esta não poderia ser utilizada novamente, uma vez que apresenta valores elevados de CQO. Para a sua reutilização, será necessário remover a CQO, hipótese que se estudou com resultados positivos. Verificou-se que, um tratamento por adsorção em carvão activado precedido de microfiltração, reduz a CQO de forma significativa permitindo admitir a hipótese de reciclagem da água, nomeadamente para as 1ª e 3ª águas de lavagem. As outras águas teriam necessidade de mais tempo de contacto com o carvão activado. No sentido de avaliar o funcionamento da ETARI, foram analisadas várias correntes da mesma, em particular a do efluente final, no que respeita a parâmetros como: pH, Sólidos Suspensos Totais, Carência Química de Oxigénio, Carência Bioquímica de Oxigénio, Turvação, Nitratos, Fósforo Total, Azoto Kjeldalh, Azoto Amoniacal e Cloretos. Observou-se que os valores para o efluente final da ETARI são os seguintes: pH compreendido entre [7,21 – 8,69], SST entre [65,3 – 3110] mg/L, CQO entre [92,5 – 711,5] mg/L, CBO5 entre [58 – 161] mg/L, NO3- entre [10,8 – 106,7] mg/L, fósforo total entre [8,3 – 64,3] mg/L, turvação entre [67,7 – 733,3] FTU e cloretos entre [459,9 – 619,81] mg/L; pode-se dizer que os parâmetros analisados se encontram quase sempre dentro da gama de valores impostos pela Câmara Municipal de Lamego pelo que o efluente pode ser lançado no Colector Municipal de Cambres. Relativamente à fermentação alcoólica do soro de queijo, verifica-se que a levedura Kluyveromyces Marxianus consegue degradar praticamente todo o açúcar presente no permeado produzindo assim uma quantidade razoável de etanol. Quando se utilizou a levedura Saccharomyces Cerevisiae, a produção de etanol foi muito reduzida, como esperado, dado que esta levedura apresenta dificuldades na metabolização da lactose. Constatou-se assim que a melhor levedura para a fermentação do permeado do soro de queijo é a Kluyveromyces Marxianus, estimando-se em 150 mg a produção de etanol por L de soro.

Sistema de reconhecimento de impressões digitais baseado em FPGA

Trabalho de Projeto para obtenção do grau de Mestre em Engenharia de Eletrónica e Telecomunicações

Condiciones hidroquímicas del mar peruano a comienzos de otoño 1997. Crucero BIC Humboldt 9704

Describe las condiciones hidroquímicas del mar peruano a comienzos de otoño 1997, efectuado en el BIC Humboldt 9704, encontrando en la superfie del mar las concentraciones de nutrientes (oxígeno, fosfatos, silicatos, nitratos y nititos) fueron bajas afuera de las cinco millas naúticas debido a las influencia de las aguas ecuatoriales superficiales y a las aguas subtropicales superficiales, masas de aguas caracterizadas por ser pobres en nutrientes y cuya presencia se debe a las condiciones anómalas de un año cálido ENOS.