Malignancy and mortality in a population-based cohort of patients with coeliac disease or 'gluten sensitivity'

Aim: To determine the risk of malignancy and mortality in patients with a positive endomysial or anti-gliadin antibody test in Northern Ireland.

Methods: A population-based retrospective cohort study design was used. Laboratory test results used in the diagnosis of coeliac disease were obtained from the Regional Immunology Laboratory, cancer statistics from the Northern Ireland Cancer Registry and mortality statistics from the General Registrar Office, Northern Ireland. Age standardized incidence ratios of malignant neoplasms and standardized mortality ratios of all-cause and cause-specific mortality were calculated.

Results: A total of 13 338 people had an endomysial antibody and/or an anti-gliadin antibody test in Northern Ireland between 1993 and 1996. There were 490 patients who tested positive for endomysial antibodies and they were assumed to have coeliac disease. There were 1133 patients who tested positive for anti-gliadin anti-bodies and they were defined as gluten sensitive. Malignant neoplasms were not significantly associated with coeliac disease; however, all-cause mortality was significantly increased following diagnosis. The standardized incidence and mortality ratios for non-Hodgkin's lymphoma were increased in coeliac disease patients but did not reach statistical significance. Lung and breast cancer incidence were significantly lower and all-cause mortality, mortality from malignant neoplasms, non-Hodgkin's lymphoma and digestive system disorders were significantly higher in gluten sensitive patients compared to the Northern Ireland population.

Conclusion: Patients with coeliac disease or gluten sensitivity had higher mortality rates than the Northern Ireland population. This association persists more than one year after diagnosis in patients testing positive for anti-gliadin antibodies. Breast cancer is significantly reduced in the cohort of patients with gluten sensitivity. © 2007 The WJG Press. All rights reserved.

Thermochemistry of Ionic Liquid-Catalyzed Reactions: Theoretical and Experimental Study of the Beckmann Rearrangement-Kinetic or Thermodynamic Control?

A thermodynamic analysis of the experimental conditions of the Beckmann rearrangement reaction of oximes into amides has been undertaken to examine whether the reaction is under thermodynamic or kinetic control. To answer this question, the thermodynamic properties of the typical Beckmann rearrangement reactions in the ideal gaseous state-cyclohexanone oxime to caprolactam and 2-butanone oxime to N-methylpropanarnide-were studied by using the quantum mechanical method. Gibbs energy and equilibrium constants of the Beckmann rearrangement have been assessed in the gaseous and the liquid phases. Results of the thermodynamic analysis have shown that Beckmann rearrange ments are kinetically controlled. Thus, a search for possible active ionic liquid based catalysts for the mild reaction conditions has been performed.

Why do they go? Empirical evidence of employees' motives for seeking or accepting relocation

This study addresses one of the shortcomings apparent in previous research on expatriate job-transfers, namely the lack of exploratory, empirical groundwork into the motives of expatriates to seek or accept international assignments. The relocatee population of a large German MNC was surveyed for their motives to seek or accept their transfer, using an open-response format. Responses were content analysed in order to arrive at an empirically grounded set of motives. The findings provide a very detailed picture of employees' motives to seek or accept international assignments and thus an important interim result that, when used as input in subsequent investigations, promises highly relevant results due to established content validity.

Why is housing tenure associated with a lower risk of admission to a nursing or residential home? Wealth, health and the incentive to keep 'my home'

Background Previous research has shown that home ownership is associated with a reduced risk of admission to institutional care. The extent to which this reflects associations between wealth and health, between wealth and ability to buy in care or increased motivation to avoid admission related to policies on charging is unclear. Taking account of the value of the home, as well as housing tenure, may provide some clarification as to the relative importance of these factors.
Aims To analyse the probability of admission to residential and nursing home care according to housing tenure and house value.
Methods Cox regression was used to examine the association between home ownership, house value and risk of care home admissions over 6 years of follow-up among a cohort of 51 619 people aged 65 years or older drawn from the Northern Ireland Longitudinal Study, a representative sample of approximate to 28% of the population of Northern Ireland.
Results 4% of the cohort (2138) was admitted during follow-up. Homeowners were less likely than those who rented to be admitted to care homes (HR 0.77, 95% CI 0.70 to 0.85, after adjusting for age, sex, health, living arrangement and urban/rural differences). There was a strong association between house value/tenure and health with those in the highest valued houses having the lowest odds of less than good health or limiting long-term illness. However, there was no difference in probability of admission according to house value; HRs of 0.78 (95% CI 0.67 to 0.90) and 0.81 (95% CI 0.70 to 0.95), respectively, for the lowest and highest value houses compared with renters.
Conclusions The requirement for people in the UK with capital resources to contribute to their care is a significant disincentive to institutional admission. This may place an additional burden on carers.

Photocatalytically active gamma-WO3 films from the atmospheric pressure CVD of WOCl4 with ethyl acetate or ethanol

Communication: Coatings Of Yellow gamma-WO3 are deposited on glass by APCVD of WOCl4 and either ethanol or ethylacetate at 350-450degreesC. The yellow films show significant photoactivity for the destruction of stearic acid, and photoinduced superhydrophilicity. Preparation of blue reduced WO2.92 films from the same reaction at higher substrate temperatures of 500-600degreesC (Figure) is also found to be possible. These films show no photoactivity, but can be converted into the fully stoichiometric photoactive form simply by heating in air.

Psychosocial factors in GP work:the effects of taking a GP position or leaving GP work

BACKGROUND: We examined the effects of leaving public sector general practitioner (GP) work and of taking a GP position on changes in work-related psychosocial factors, such as time pressure, patient-related stress, distress and work interference with family. In addition, we examined whether changes in time pressure and patient-related stress mediated the association of employment change with changes of distress and work interference with family. METHODS: Participants were 1705 Finnish physicians (60% women) who responded to surveys in 2006 and 2010. Analyses of covariance were conducted to examine the effect of employment change to outcome changes adjusted for gender, age and response format. Mediational effects were tested following the procedures outlined by Baron and Kenny. RESULTS: Employment change was significantly associated with all the outcomes. Leaving public sector GP work was associated with substantially decreased time pressure, patient-related stress, distress and work interference with family. In contrast, taking a position as a public sector GP was associated with an increase in these factors. Mediation tests suggested that the associations of employment change with distress change and work interference with family change were partially explained by the changes in time pressure and patient-related stress. CONCLUSIONS: Our results showed that leaving public sector GP work is associated with favourable outcomes, whereas taking a GP position in the public sector is associated with adverse effects. Primary health-care organizations should pay more attention to the working conditions of their GPs, in particular, to time pressure and patient-related stress.

Autonomy and regulation of state agencies:Reinforcement, indifference or compensation?

This paper analyses the relationships between the autonomy and regulation of state agencies in Norway, Ireland and Flanders (Belgium). The empirical basis is provided by broad surveys of public sector organizations carried out in 2002-2004. Three hypotheses on these relationships are formulated and examined, indicating different patterns. The reinforcement hypothesis, stating a negative relationship does not get any support. On the other hand, the compensation hypothesis, stating a positive relationship gets some support. In general, however, the indifference hypothesis, stating low or no correlations seems to be the most adequate. The hypotheses are also linked to prevalent administrative doctrines, and the empirical findings indicate how relevant they are. © Springer Science+Business Media, LLC 2008.

Cooperative traits of technology adoption: Website adoption in Irish credit unions

The purpose of this paper is to examine website adoption and its resultant effects on credit union performance in Ireland. Credit union specific factors influence adoption as does the socio-economic profile of the population from where the credit union draws its membership. Website adoption results in a reduction in the spread between the loan and dividend rate with this primarily driven by a fall in the loan rate. Given that the adoption of a website, albeit with limited functionality, translates into cost benefits this augurs well for the current restructuring process underway for Irish credit unions which has as one of its objectives the upgrade of credit union ICT sophistication.