Smokers:At risk for prostate cancer but unlikely to screen

Prostate cancer is the most commonly diagnosed cancer in men. Evidence suggests that smokers may be at increased risk of prostate cancer compared to non-smokers. In the present study we ask whether adult men who smoke are also less likely to undergo screening for prostate cancer. Adult men aged 46 and above completed a single questionnaire including demographic items and items concerning their smoking status and previous testing for prostate cancer. The questionnaire also included an 11 item numeracy scale. Compared to smokers, non-smokers and ex-smokers were around two times more likely to have undergone screening for prostate cancer, and had been tested more frequently. Smokers are not only more likely to develop prostate cancer, they are, paradoxically, less likely to undergo screening for prostate cancer. Health care professionals need to be cognizant of individual differences in screening behavior and that smokers have a reduced likelihood of choosing to screen. © 2012 Elsevier Ltd.

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.

High-contrast imaging search for planets and brown dwarfs around the most massive stars in the solar neighborhood

There has been a long-standing discussion in the literature as to whether core accretion or disk instability is the dominant mode of planet formation. Over the last decade, several lines of evidence have been presented showing that core accretion is most likely the dominant mechanism for the close-in population of planets probed by radial velocity and transits. However, this does not by itself prove that core accretion is the dominant mode for the total planet population, since disk instability might conceivably produce and retain large numbers of planets in the far-out regions of the disk. If this is a relevant scenario, then the outer massive disks of B-stars should be among the best places for massive planets and brown dwarfs to form and reside. In this study, we present high-contrast imaging of 18 nearby massive stars of which 15 are in the B2-A0 spectral-type range and provide excellent sensitivity to wide companions. By comparing our sensitivities to model predictions of disk instability based on physical criteria for fragmentation and cooling, and using Monte Carlo simulations for orbital distributions, we find that ~85% of such companions should have been detected in our images on average. Given this high degree of completeness, stringent statistical limits can be set from the null-detection result, even with the limited sample size. We find that

Genetic Markers Enhance Coronary Risk Prediction in Men: The MORGAM Prospective Cohorts

Background: More accurate coronary heart disease (CHD) prediction, specifically in middle-aged men, is needed to reduce the burden of disease more effectively. We hypothesised that a multilocus genetic risk score could refine CHD prediction beyond classic risk scores and obtain more precise risk estimates using a prospective cohort design.

Methods: Using data from nine prospective European cohorts, including 26,221 men, we selected in a case-cohort setting 4,818 healthy men at baseline, and used Cox proportional hazards models to examine associations between CHD and risk scores based on genetic variants representing 13 genomic regions. Over follow-up (range: 5-18 years), 1,736 incident CHD events occurred. Genetic risk scores were validated in men with at least 10 years of follow-up (632 cases, 1361 non-cases). Genetic risk score 1 (GRS1) combined 11 SNPs and two haplotypes, with effect estimates from previous genome-wide association studies. GRS2 combined 11 SNPs plus 4 SNPs from the haplotypes with coefficients estimated from these prospective cohorts using 10-fold cross-validation. Scores were added to a model adjusted for classic risk factors comprising the Framingham risk score and 10-year risks were derived.

Results: Both scores improved net reclassification (NRI) over the Framingham score (7.5%, p = 0.017 for GRS1, 6.5%, p = 0.044 for GRS2) but GRS2 also improved discrimination (c-index improvement 1.11%, p = 0.048). Subgroup analysis on men aged 50-59 (436 cases, 603 non-cases) improved net reclassification for GRS1 (13.8%) and GRS2 (12.5%). Net reclassification improvement remained significant for both scores when family history of CHD was added to the baseline model for this male subgroup improving prediction of early onset CHD events.

Conclusions: Genetic risk scores add precision to risk estimates for CHD and improve prediction beyond classic risk factors, particularly for middle aged men.

Selective Targeting of Glucagon-Like Peptide-1 Signalling As a Novel Therapeutic Approach for Cardiovascular Disease in Diabetes

Glucagon-like peptide-1 (GLP-1) is an incretin hormone whose glucose-dependent insulinotropic actions have been harnessed as a novel therapy for glycaemic control in type 2 diabetes. Although it has been known for some time that the GLP-1 receptor is expressed in the cardiovascular system where it mediates important physiological actions, it is only recently that specific cardiovascular effects of GLP-1 in the setting of diabetes have been described. GLP-1 confers indirect benefits in cardiovascular disease (CVD) under both normal and hyperglycaemic conditions via reducing established risk factors, such as hypertension, dyslipidaemia and obesity, which are markedly increased in diabetes. Emerging evidence indicates that GLP-1 also exerts direct effects on specific aspects of diabetic CVD, such as endothelial dysfunction, inflammation, angiogenesis and adverse cardiac remodelling. However, the majority of studies have employed experimental models of diabetic CVD and information on the effects of GLP-1 in the clinical setting are limited although several large-scale trials are ongoing. It is clearly important to gain a detailed knowledge of the cardiovascular actions of GLP-1 in diabetes given the large number of patients currently receiving GLP-1 based therapies. This review will therefore discuss current understanding of the effects of GLP-1 on both cardiovascular risk factors in diabetes and direct actions on the heart and vasculature in this setting, and the evidence implicating specific targeting of GLP-1 as a novel therapy for CVD in diabetes.

The Work of Sisyphus: Squaring the Circle of Roma Recognition

Most special issues on Roma minorities want to alert readers to the devastating consequences of racist public attitudes and misdirected public policy. Here we don't shy away from such issues, but we also want to challenge our own scholarship and ask some fundamental questions about how we, as academics, are approaching such research. In this introduction the context of the special issue is explored, both in terms of the historic backdrop of an expanding European Union and the academic theoretical framework of minority integration. Major critical questioning – such as broader questions around migration, race and ethnicity discourses – are still lacking when it comes to research on or with Roma minorities. Our main aim is to move debates on from continually describing who Roma people are and what they are doing, to questioning: who defines who is Roma, when and why? What happens in policy-making, research, everyday interactions? This approach sees an understanding of recognition, representations and power dynamics as fundamental to understanding the positionings of minorities who can also be marginalised or feel disenfranchised. This introduction to the special issue highlights the importance of deeply conceptualising issues around minority integration alongside empirical knowledge of how Roma identities become implicated in and through different modalities of mobilisation. Contributions to this special issue speak to debates in minority politics and identity studies along with migration and race/ethnicity discourses. This indicates that the experiences of, and discourses surrounding Roma minorities reflect the fundamental concerns of social science research about identity, ethnicity, cohesion and change.

A Scheme Design of Cloud + End Technology in Demand Side Management

Demand Side Management (DSM) plays an important role in Smart Grid. It has large scale access points, massive users, heterogeneous infrastructure and dispersive participants. Moreover, cloud computing which is a service model is characterized by resource on-demand, high reliability and large scale integration and so on and the game theory is a useful tool to the dynamic economic phenomena. In this study, a scheme design of cloud + end technology is proposed to solve technical and economic problems of the DSM. The architecture of cloud + end is designed to solve technical problems in the DSM. In particular, a construct model of cloud + end is presented to solve economic problems in the DSM based on game theories. The proposed method is tested on a DSM cloud + end public service system construction in a city of southern China. The results demonstrate the feasibility of these integrated solutions which can provide a reference for the popularization and application of the DSM in china.

O que o estado português quis conservar: a avaliação e aquisição de documentos de arquivo em Portugal nos séculos XIX e XX

Esta dissertação procura identificar os desígnios que orientaram as decisões do Estado português em relação à aquisição de documentos de arquivo, com o objectivo de verificar se esses desígnios se formalizaram numa política de avaliação e aquisição de documentos de arquivo coerente e sistemática. A análise incidiu no Arquivo Nacional e nos arquivos distritais durante o período cronológico que abrange o século XIX e a primeira metade do século XX. Partindo da discussão teórica presente nos discursos de arquivistas e investigadores, da evolução das práticas no Arquivo Nacional e das incorporações realizadas nos arquivos distritais, esta tese defende que existiu uma visão constitutiva dos arquivos enquanto repositórios documentais da memória da nação. No entanto, esta visão não se concretizou numa política arquivística articulada e estrutural; ABSTRACT:This dissertation aims to identify portuguese state’s goals that guided its intervention on acquisition of archival records. Our purpose is to verify if those goals meant a coherent and systematic appraisal and acquisition policy. Our analysis took as object Portugal’s national and regional archives from nineteenth to twentieth century’s first half. Beginning from theoretical discussion that can be seen on archivists and investigators speeches, National Archive’s practices and acquisitions occurred in regional archives, this thesis sustains that there was a vision on the archives as national memory documental repositories. However, this vision was not translated on an articulated and structured archival policy.

A ideia de Europa na imprensa desportiva portuguesa (1893-1945)

Pensar a Europa e Portugal, a partir da imprensa desportiva portuguesa, é o principal objectivo deste trabalho, que deve ser visto como uma espécie de "viagem" por um tempo conturbado (1893-1945), com os principais jornais desportivos a servirem de guia. Esta longa peregrinação de 52 anos — iniciada quando surge o primeiro jornal desportivo em Portugal e encerrada no ano em que termina a Segunda Guerra Mundial (altura em que este género de imprensa se consolida) — permitiu recuperar, simultaneamente, do baú do esquecimento, reflexões sobre a Europa e Portugal, e um pedaço da esquecida história da imprensa desportiva. /***Abstract - The main goal of this work is to think Europe and Portugal starting from the discourses produced in the portuguese spod press on the subject. This research must be seen as a “journey" through a troubled time (1893-1945), with the sport newspapers as guides. It's a long way of 52 years that started when the first portuguese sport newspaper born and finished at the end of the Second World War (period when Chis kind of press was already established) permitted, at the same time, a recovery, from the chests of forgetfulness, of reflections about Europe and Portugal and a piece of forgotten sport press history.

Arquivos de casas-museu. O arquivo da casa dos patudos - Parte I e II

Esta dissertação aborda a problemática dos acervos arquivísticos de casasmuseu em Portugal. Estas instituições são comummente associadas à perpetuação da memória de uma personalidade. São objetivos deste projeto a identificação dos arquivos, a recolha de informações sobre o tratamento arquivístico e sobre as funções que desempenham nas instituições. Para a consecução destes objetivos foi realizado um inquérito. A análise dos dados recolhidos revela uma realidade longe do desejável. Muitos acervos ainda não foram alvo de tratamento. Verificou-se que a utilização dos acervos nas tarefas museológicas é, em alguns casos, incipiente. Como resultado final deste trabalho, apresentamos um guia dos acervos à guarda das casas-museu em Portugal. Constitui, ainda, objeto deste projeto o arquivo da Casa dos Patudos - Museu de Alpiarça. É feita a apresentação desta instituição, dos contextos e produtores, bem uma análise do acervo arquivístico e do seu contributo para as atividades museológicas; ABSTRACT: Archives of house-museums. The Archive of the House of Patudos. This dissertation addresses the problematic of archives of house museums in Portugal. These institutions are commonly associated with the perpetuation of the memory of a personality. The objectives of this project are the identification of the archives, the gathering of information about the archival treatment and about the functions that they perform in the institutions. To the attainment of these objectives an inquiry was made. The analysis of the collected data reveals an undesirable reality. Many collections are still not the object of any treatment. It was verified that the use of collections in museological tasks is, in some cases, incipient. As a final result of this thesis, we have presented a guide of the collections in the care of house museums in Portugal. Another objective of this project is the archive of House of Patudos – Museum of Alpiarça. It is made the presentation of this institution, the context and the producers, as well as an analysis of the archive and its functions of the archive in the performance of the museological activities.

Classificação automática de documentos de arquivo corrente: estudo de caso sobre a Câmara Municipal de Palmela

Esta dissertação tem como propósito averiguar a aplicabilidade das metodologias de categorização ou classificação automática à classificação em arquivo corrente nas Câmaras Municipais, partindo do Município de Palmela como estudo de caso. A classificação continua a ser de fundamental importância numa época de proliferação de documentos eletrónicos e de sistemas informáticos que os gerem e uma solução que a simplifique e agilize mantendo a sua eficiência seria uma mais-valia. Os objetivos, numa primeira parte, serão caracterizar a classificação em arquivo e a importância da sua definição e implementação desde a origem e incluída em sistemas informáticos, e numa segunda parte caracterizar a tarefa de categorização ou classificação automática, a sua possível relação com a classificação em arquivo e a possibilidade de a automatizar. Para tal, foi realizado um teste e avaliação de resultados. Os resultados experimentais permitiram validar a hipótese colocada. /ABSTRACT - This essay has as intention to inquire the applicability of automatic categorization or classification methodologies to the classification of current archives of the City councils, having the City council of Palmela as case study. Classification continues to be of basic importance at a time of proliferation of electronic documents and informatics systems that manage them and a solution that simplifies and speeds it maintaining its efficiency would be of major value. The purposes will be, in the first chapters, to characterize classification in archives and the importance of its definition and implementation since the origin, in City councils and enclosed in those systems, and in the last chapters, to characterize the task of automatic categorization or classification, its possible relation with archival classification and the possibility of automatizing it. A test and evaluation of its results were made. The experimental results validate the hypothesis placed.

Contribuição para o estudo das tipologias documentais na administração municipal portuguesa: a Câmara Municipal de Portalegre

O presente trabalho desenvolve-se em duas partes, a teórica e a prática. Resultando na introdução aos temas da diplomática contemporânea como metodologia para analisar os documentos de um arquivo concreto (a autarquia de Portalegre). Perspectivou-se a metodologia consubstanciada numa abordagem ascendente (Bottom up) sem, no entanto, esquecer o trabalho antecedente que preparou o terreno para a aplicação do método diplomático. Esse trabalho assentou numa consistente caracterização da organização em todos os seus parâmetros, orgânico, funcional, regional, legal, social, documental, que permitiu com segurança o preenchimento das fichas de recolha dos documentos escolhidos. A parte prática revela a aplicação da análise diplomática e sintetiza a sua utilidade nas conclusões e propostas de melhoria nas funções arquivísticas, de classificação e comunicação. Aflorou-se levemente a questão do manual de procedimentos, como subproduto deste tipo de análise, que pode verdadeiramente funcionar como elo de ligação entre o arquivo e a organização. ABSTRACT: This paper develops in two parts, theory and practice. Introduces the theme contemporary diplomatic as a method to analyze the documents for a specific archive (The municipality of Portalegre). Prospect of the methodology reflected in a bottom-up approach, without forgetting the previous work, which paved the way for the application of diplomatic methods. It was based on a consistent characterization of the organization in all of its parameters: organic, functional, regional, legal, social, documentary, allowing safe completion of the characterization form of the chosen documents. A practical application of diplomatic analysis reveals and summarizes the usefulness of the findings and proposals for improvement in archival functions - classification and communication. It was touched lightly the issue of the procedures manual, as a byproduct of this type of analysis, that can truly function as a link between the archive and the organization

Thunderstorm Related Asthma - the Epidemic of 24/25 June 1994

Background A large epidemic of asthma occurred following a thunderstorm in southern and central England on 24/25 June 1994. A collaborative study group was formed. Objectives To describe the epidemic and the meteorological, aerobiological and other environmental characteristics associated with it. Methods Collation of data from the Meteorological Office, the Pollen Research Unit, the Department of the Environment's Automatic Urban Network, from health surveillance by the Department of Health and the National Poisons Unit, from clinical experience in general practice and hospitals, and from an immunological study of some of the affected cases from north east London. Results The thunderstorm was a Mesoscale Convective System, an unusual and large form of storm with several centres and severe wind gusts. It occurred shortly after the peak grass pollen concentration in the London area. A sudden and extensive epidemic occurred within about an hour affecting possibly several thousand patients. Emergency services were stretched but the epidemic did not last long. Cases had high serum levels of IgE antibody to mixed grass pollen. Conclusion This study supports the view that patients with specific IgE to grass pollen are at risk of thunderstorm-related asthma. The details of the causal pathway from storm to asthma attack are not clear. Case-control and time series studies are being carried out.

Senior Managers’ Perspectives of Leading and Managing Effective, Sustainable and Successful Partnerships

Formal and informal partnerships have become key features of education policy and practice in many countries and managing such collaborative arrangements is an important dimension of the role(s) of leaders of educational organizations. Recent research has shown both the tensions and conflict that can develop in partnerships as well as the opportunities and benefits of partnership working for organizations and individuals. This article focuses on the characteristics of partnerships that contribute to their effectiveness, sustainability and success, filling a gap in the literature on educational partnerships. The research data emanate from a qualitative study of partnership working in England. The study used a grounded approach and inductively linked characteristics of partnerships found in the partnership literature with empirical data from a case study of a subregional partnership of education and training organizations. This combined evidence is used to conceptualize partnership as a continuum of weak to strong forms of partnership and to develop a table of characteristics which underpin such partnerships. The findings reveal the extent to which trust, networks, norms and values support effective, sustained and successful partnerships. These characteristics are differentiated and may fluctuate during the lifecourse of a partnership but remain fundamental features of partnership working and significantly contribute to the strength and effectiveness of partnerships.

Retinal pigment epithelium tears after intravitreal injection of ranibizumab for predominantly classic neovascular membranes secondary to age-related macular degeneration.

PURPOSE: Retinal pigment epithelium (RPE) tear is an extremely rare complication in patients with classic neovascular membranes without RPE detachment. We evaluate their incidence and functional outcome following treatment with intravitreal ranibizumab. METHODS: Observational study of 72 consecutive patients (74 eyes) treated at Jules Gonin University Eye Hospital, Lausanne, with intravitreal ranibizumab 0.5 mg for classic choroidal neovascularization (CNV) between March 2006 and February 2008. Best-corrected visual acuity (BCVA), fundus examination and optical coherence tomography were recorded monthly; fluorescein angiography was performed at baseline and repeated at least every 3 months. RESULTS: RPE tears occurred in four (5.4%) eyes temporal to the fovea, after a mean of four injections (range 3-6). Mean baseline BCVA was 0.25 decimal equivalent (logMAR 0.67) and improved despite the RPE tear to 0.6 decimal equivalent (logMAR 0.22). CONCLUSION: RPE tears following intravitreal ranibizumab injections for classic CNV can occur in about 5% of patients, even in the absence of baseline RPE detachment. Nevertheless, vision may improve provided the fovea is not involved.