Salume arricchito in acidi grassi polinsaturi omega-3: controllo delle caratteristiche sensoriali in relazione ad un possibile incremento di ossidabilità della frazione lipidica durante la shelf-life.

Questa relazione finale è stata frutto di un lavoro sperimentale svolto in collaborazione con un’azienda del territorio ed ha avuto come obiettivo principale quello di verificare i parametri qualitativi e compositivi di una nuova tipologia di salume in fase di studio. L’azienda sta studiando una nuova tipologia di “prodotto funzionale” addizionando componenti ad attività nutraceutica al salame ottenuto da sole parti magre di suino. L’intenzione dell’azienda è di arricchire il proprio prodotto con acidi grassi polinsaturi della serie omega-3 (da olio di semi di lino), noti per gli effetti benefici che possono esercitare sulla salute umana. A questo scopo, sul prodotto di nuova formulazione (ed in parallelo sul prodotto a formulazione classica e su un prodotto del tutto simile commercializzato da un’altra azienda) sono state effettuate sia la determinazione della percentuale lipidica, al fine di individuare il quantitativo totale di grasso, che una caratterizzazione gascromatografica del profilo quali-quantitativo in acidi grassi, analsi fondamentale per verificare la conformità con i requisiti indicati dal Reg. 1924/06, e successive modifiche, previsti per le indicazioni da inserire in etichetta (claims). Inoltre, è stato importante controllare che la concentrazione voluta di acido alfa-linolenico si mantenga tale durante tutto il periodo di shelf-life del prodotto (45 gg), perciò per soddisfare quest’ultima finalità, le analisi sono state eseguite sia all’inizio (T0) che alla fine (T1) della vita commerciale del prodotto. E’ apparso poi fondamentale monitorare un possibile decadimento/modifica della qualità organolettica del prodotto di nuova formulazione, a causa del possibile aumento di ossidabilità della frazione lipidica causata da una maggiore presenza di acidi grassi polinsaturi; ed infine, con l’intento di verificare se la nuova formulazione potesse comportare una variazione significativa delle caratteristiche sensoriali del prodotto, sono stati condotti un test descrittivo quantitativo (QDA), in grado di descrivere il profilo sensoriale del prodotto ed un test discriminante qualitativo (metodo triangolare) capace di valutare l’eventuale comparsa di cambiamenti in seguito alle modifiche apportate al prodotto; per ultimo è stato poi eseguito un test affettivo quantitativo (test di preferenza, condotto su scala di laboratorio) in grado fornire informazioni sul gradimento e di evidenziare i principali vettori che guidano le scelte dei consumatori. I risultati delle analisi chimiche e sensoriali, eseguite per soddisfare tali richieste, hanno evidenziato come il salume presenti un quantitativo di tali acidi grassi polinsaturi in linea con il claim “Alimento fonte di acidi grassi omega-3”, (requisiti indicati dal Reg. 1924/06 e successive modifiche), risultato confermato sia all’inizio che al termine della vita commerciale del prodotto (pari a circa 45 giorni). Inoltre, esso risulta essere piuttosto interessante dal punto di vista nutrizionale, poiché caratterizzato da un contenuto di grasso per la categoria dei salumi, relativamente limitato, pari a circa il 15%, con percentuali più favorevoli in acidi grassi insaturi. L’analisi del profilo sensoriale condotta ad inizio shelf-life ha invece evidenziato come questa tipologia di prodotto sia caratterizzata sia al gusto che all’olfatto da note più sapide e speziate , oltre ad una maggiore consistenza della fetta, rispetto agli altri campioni analizzati, mentre i risultati relativi al termine della shelf-life hanno evidenziato come esso tenda ad essere soggetto ad alterazioni sensoriali rilevabili proprio al termine della fase di conservazione dovute nello specifico alla formazione di composti responsabili dell’odore di rancido. I test discriminanti, condotti con giudici non allenati, non hanno invece fatto registrare differenze sensoriali significative tra il prodotto con formulazione classica e quello di nuova formulazione, confrontati ad inizio e a fine shelf-life. Riassumendo, dai risultati ottenuti da questo lavoro sperimentale, il prodotto di nuova formulazione, arricchito in acidi grassi polinsaturi della serie omega-3, risulta essere in linea con il claim “Alimento fonte di acidi grassi omega-3”, presenta in generale un contenuto di grasso totale inferiore a quello di altre tipologie di salumi ed un rapporto più favorevole tra acidi grassi insaturi e saturi, per questo può essere considerato un prodotto interessante dal punto di vista della salute e della nutrizione. Proprio per la sua formulazione più ricca in acidi grassi polinsaturi, tende però a fine shelf-life a presentare una leggera nota di rancido, riconducibile ad una maggiore ossidabilità della frazione lipidica. Tale variazione sensoriale è risultata comunque percepita solo da un panel allenato, mentre un test di tipo discriminante, condotto con giudici non allenati, non ha messo in luce differenze significative tra il salume di nuova formulazione e quello con formulazione classica né all’inizio, né al termine della vita commerciale del prodotto.

Development of Software Tools for the Test of Ultra Wide Band Receivers

In the last years, the importance of locating people and objects and communicating with them in real time has become a common occurrence in every day life. Nowadays, the state of the art of location systems for indoor environments has not a dominant technology as instead occurs in location systems for outdoor environments, where GPS is the dominant technology. In fact, each location technology for indoor environments presents a set of features that do not allow their use in the overall application scenarios, but due its characteristics, it can well coexist with other similar technologies, without being dominant and more adopted than the others indoor location systems. In this context, the European project SELECT studies the opportunity of collecting all these different features in an innovative system which can be used in a large number of application scenarios. The goal of this project is to realize a wireless system, where a network of fixed readers able to query one or more tags attached to objects to be located. The SELECT consortium is composed of European institutions and companies, including Datalogic S.p.A. and CNIT, which deal with software and firmware development of the baseband receiving section of the readers, whose function is to acquire and process the information received from generic tagged objects. Since the SELECT project has an highly innovative content, one of the key stages of the system design is represented by the debug phase. This work aims to study and develop tools and techniques that allow to perform the debug phase of the firmware of the baseband receiving section of the readers.

Valutazione del Fattore di Effetto nella metodologia LCA: test sperimentali di tossicità indotti da nanoparticelle di Diossido di Titanio sull’alga Pseudokirchneriella Subcapitata

La nanotecnologia è una scienza innovativa che sviluppa e utilizza materiali di dimensioni nanometriche (< 100 nm). Lo sviluppo e il mercato delle nanoparticelle in merito alle loro interessanti proprietà chimico‐fisiche, é accompagnato da una scarsa conoscenza relativa al destino finale e agli effetti che questi nano materiali provocano nell’ ambiente [Handy et al., 2008]. La metodologia LCA (Life Cycle Assessment – Valutazione del Ciclo di Vita) è riconosciuta come lo strumento ideale per valutare e gestire gli impatti ambientali indotti dalle ENPs, nonostante non sia ancora possibile definire, in maniera precisa, un Fattore di Caratterizzazione CF per questa categoria di sostanze. Il lavoro di questa tesi ha l’obbiettivo di stimare il Fattore di Effetto EF per nanoparticelle di Diossido di Titanio (n‐TiO2) e quindi contribuire al calcolo del CF; seguendo il modello di caratterizzazione USEtox, l’EF viene calcolato sulla base dei valori di EC50 o LC50 relativi agli organismi appartenenti ai tre livelli trofici di un ecosistema acquatico (alghe, crostacei, pesci) e assume valore pari a 49,11 PAF m3/Kg. I valori tossicologici utilizzati per il calcolo del Fattore di Effetto derivano sia da un’accurata ricerca bibliografica sia dai risultati ottenuti dai saggi d’inibizione condotti con n‐TiO2 sulla specie algale Pseudokirchneriella Subcapitata. La lettura dei saggi è stata svolta applicando tre differenti metodi quali la conta cellulare al microscopio ottico (media geometrica EC50: 2,09 mg/L, (I.C.95% 1,45‐ 2,99)), l’assorbanza allo spettrofotometro (strumento non adatto alla lettura di test condotti con ENPs) e l’intensità di fluorescenza allo spettrofluorimetro (media geometrica EC50: 3,67 mg/L (I.C.95% 2,16‐6,24)), in modo tale da confrontare i risultati e valutare quale sia lo strumento più consono allo studio di saggi condotti con n‐TiO2. Nonostante la grande variabilità dei valori tossicologici e la scarsa conoscenza sui meccanismi di tossicità delle ENPs sulle specie algali, il lavoro sperimentale e la ricerca bibliografica condotta, hanno permesso di individuare alcune proprietà chimico‐fisiche delle nanoparticelle di Diossido di Titanio che sembrano essere rilevanti per la loro tossicità come la fase cristallina, le dimensioni e la foto attivazione [Vevers et al., 2008; Reeves et al., 2007]. Il lavoro sperimentale ha inoltre permesso di ampliare l’insieme di valori di EC50 finora disponibile in letteratura e di affiancare un progetto di ricerca dottorale utilizzando il Fattore di Effetto per n‐ TiO2 nel calcolo del Fattore di Caratterizzazione.

Qualifica a Vibrazioni di Componenti Meccanici: Studio e Verifica di una Procedura di Test Tailoring.

I test di qualifica a vibrazioni vengono usati in fase di progettazione di un componente per verificarne la resistenza meccanica alle sollecitazioni dinamiche (di natura vibratoria) applicate durante la sua vita utile. La durata delle vibrazioni applicate al componente durante la sua vita utile (migliaia di ore) deve essere ridotta al fine di realizzare test fattibili in laboratorio, condotti in genere utilizzando uno shaker elettrodinamico. L’idea è quella di aumentare l’intensità delle vibrazioni riducendone la durata. Esistono diverse procedure di Test Tailoring che tramite un metodo di sintesi definiscono un profilo vibratorio da applicare in laboratorio a partire dalle reali vibrazioni applicate al componente: una delle metodologie più comuni si basa sull’equivalenza del danno a fatica prodotto dalle reali vibrazioni e dalle vibrazioni sintetizzate. Questo approccio è piuttosto diffuso tuttavia all’autore non risulta presente nessun riferimento in letteratura che ne certifichi la validità tramite evidenza sperimentalmente. L’obiettivo dell’attività di ricerca è stato di verificare la validità del metodo tramite una campagna sperimentale condotta su opportuni provini. Il metodo viene inizialmente usato per sintetizzare un profilo vibratorio (random stazionario) avente la stessa durata di un profilo vibratorio non stazionario acquisito in condizioni reali. Il danno a fatica prodotto dalla vibrazione sintetizzata è stato confrontato con quello della vibrazione reale in termini di tempo di rottura dei provini. I risultati mostrano che il danno prodotto dalla vibrazione sintetizzata è sovrastimato, quindi l’equivalenza non è rispettata. Sono stati individuati alcuni punti critici e sono state proposte alcune modifiche al metodo per rendere la teoria più robusta. Il metodo è stato verificato con altri test e i risultati confermano la validità del metodo a condizione che i punti critici individuati siano correttamente analizzati.

Methods and strategies to identify the mode of action of phytoactive compounds

Small molecules affecting biological processes in plants are widely used in agricultural practice as herbicides or plant growth regulators and in basic plant sciences as probes to study the physiology of plants. Most of the compounds were identified in large screens by the agrochemical industry, as phytoactive natural products and more recently, novel phytoactive compounds originated from academic research by chemical screens performed to induce specific phenotypes of interest. The aim of the present PhD thesis is to evaluate different approaches used for the identification of the primary mode of action (MoA) of a phytoactive compound. Based on the methodologies used for MoA identification, three approaches are discerned: a phenotyping approach, an approach based on a genetic screen and a biochemical screening approach.rnFour scientific publications resulting from my work are presented as examples of how a phenotyping approach can successfully be applied to describe the plant MoA of different compounds in detail.rnI. A subgroup of cyanoacrylates has been discovered as plant growth inhibitors. A set of bioassays indicated a specific effect on cell division. Cytological investigations of the cell division process in plant cell cultures, studies of microtubule assembly with green fluorescent protein marker lines in vivo and cross resistant studies with Eleusine indica plants harbouring a mutation in alpha-tubulin, led to the description of alpha-tubulin as a target site of cyanoacrylates (Tresch et al., 2005).rnII. The MoA of the herbicide flamprop-m-methyl was not known so far. The studies described in Tresch et al. (2008) indicate a primary effect on cell division. Detailed studies unravelled a specific effect on mitotic microtubule figures, causing a block in cell division. In contrast to other inhibitors of microtubule rearrangement such as dinitroanilines, flamprop-m-methyl did not influence microtubule assembly in vitro. An influence of flamprop-m-methyl on a target within the cytoskeleton signalling network could be proposed (Tresch et al., 2008).rnIII. The herbicide endothall is a protein phosphatase inhibitor structurally related to the natural product cantharidin. Bioassay studies indicated a dominant effect on dark-growing cells that was unrelated to effects observed in the light. Cytological characterisation of the microtubule cytoskeleton in corn tissue and heterotrophic tobacco cells showed a specific effect of endothall on mitotic spindle formation and ultrastructure of the nucleus in combination with a decrease of the proliferation index. The observed effects are similar to those of other protein phosphatase inhibitors such as cantharidin and the structurally different okadaic acid. Additionally, the observed effects show similarities to knock-out lines of the TON1 pathway, a protein phosphatase-regulated signalling pathway. The data presented in Tresch et al. (2011) associate endothall’s known in vitro inhibition of protein phosphatases with in vivo-effects and suggest an interaction between endothall and the TON1 pathway.rnIV. Mefluidide as a plant growth regulator induces growth retardation and a specific phenotype indicating an inhibition of fatty acid biosynthesis. A test of the cuticle functionality suggested a defect in the biosynthesis of very-long-chain fatty acids (VLCFA) or waxes. Metabolic profiling studies showed similarities with different groups of VLCFA synthesis inhibitors. Detailed analyses of VLCFA composition in tissues of duckweed (Lemna paucicostata) indicated a specific inhibition of the known herbicide target 3 ketoacyl-CoA synthase (KCS). Inhibitor studies using a yeast expression system established for plant KCS proteins verified the potency of mefluidide as an inhibitor of plant KCS enzymes. It could be shown that the strength of inhibition varied for different KCS homologues. The Arabidopsis Cer6 protein, which induces a plant growth phenotype similar to mefluidide when knocked out, was one of the most sensitive KCS enzymes (Tresch et al., 2012).rnThe findings of my own work were combined with other publications reporting a successful identification of the MoA and primary target proteins of different compounds or compound classes.rnA revised three-tier approach for the MoA identification of phytoactive compounds is proposed. The approach consists of a 1st level aiming to address compound stability, uniformity of effects in different species, general cytotoxicity and the effect on common processes like transcription and translation. Based on these findings advanced studies can be defined to start the 2nd level of MoA characterisation, either with further phenotypic characterisation, starting a genetic screen or establishing a biochemical screen. At the 3rd level, enzyme assays or protein affinity studies should show the activity of the compound on the hypothesized target and should associate the in vitro effects with the in vivo profile of the compound.

Measurement of LSP-induced residual stresses and fatigue life on thin-walled aluminium alloys specimens

This thesis work encloses activities carried out in the Laser Center of the Polytechnic University of Madrid and the laboratories of the University of Bologna in Forlì. This thesis focuses on the superficial mechanical treatment for metallic materials called Laser Shock Peening (LSP). This process is a surface enhancement treatment which induces a significant layer of beneficial compressive residual stresses underneath the surface of metal components in order to improve the detrimental effects of the crack growth behavior rate in it. The innovation aspect of this work is the LSP application to specimens with extremely low thickness. In particular, after a bibliographic study and comparison with the main treatments used for the same purposes, this work analyzes the physics of the operation of a laser, its interaction with the surface of the material and the generation of the surface residual stresses which are fundamentals to obtain the LSP benefits. In particular this thesis work regards the application of this treatment to some Al2024-T351 specimens with low thickness. Among the improvements that can be obtained performing this operation, the most important in the aeronautic field is the fatigue life improvement of the treated components. As demonstrated in this work, a well-done LSP treatment can slow down the progress of the defects in the material that could lead to sudden failure of the structure. A part of this thesis is the simulation of this phenomenon using the program AFGROW, with which have been analyzed different geometric configurations of the treatment, verifying which was better for large panels of typical aeronautical interest. The core of the LSP process are the residual stresses that are induced on the material by the interaction with the laser light, these can be simulated with the finite elements but it is essential to verify and measure them experimentally. In the thesis are introduced the main methods for the detection of those stresses, they can be mechanical or by diffraction. In particular, will be described the principles and the detailed realization method of the Hole Drilling measure and an introduction of the X-ray Diffraction; then will be presented the results I obtained with both techniques. In addition to these two measurement techniques will also be introduced Neutron Diffraction method. The last part refers to the experimental tests of the fatigue life of the specimens, with a detailed description of the apparatus and the procedure used from the initial specimen preparation to the fatigue test with the press. Then the obtained results are exposed and discussed.

Determination of Pelvic Orientation from Ultrasound Images Using Patch-SSMs and a Hierarchical Speed of Sound Compensation Strategy

In the field of computer assisted orthopedic surgery (CAOS) the anterior pelvic plane (APP) is a common concept to determine the pelvic orientation by digitizing distinct pelvic landmarks. As percutaneous palpation is - especially for obese patients - known to be error-prone, B-mode ultrasound (US) imaging could provide an alternative means. Several concepts of using ultrasound imaging to determine the APP landmarks have been introduced. In this paper we present a novel technique, which uses local patch statistical shape models (SSMs) and a hierarchical speed of sound compensation strategy for an accurate determination of the APP. These patches are independently matched and instantiated with respect to associated point clouds derived from the acquired ultrasound images. Potential inaccuracies due to the assumption of a constant speed of sound are compensated by an extended reconstruction scheme. We validated our method with in-vitro studies using a plastic bone covered with a soft-tissue simulation phantom and with a preliminary cadaver trial.

Quality of life 9 years after an intensive care unit stay: A long-term outcome study

The purpose of the study was to assess long-term mortality after an intensive care unit (ICU) stay and to test the hypotheses that (1) quality of life improves over time and (2) predictions of outcome made by caregivers during an ICU stay are reliable.

Development of a novel fMRI compatible visual perception prototype battery to test older people with and without dementia

Background: Visuoperceptual deficits in dementia are common and can reduce quality of life. Testing of visuoperceptual function is often confounded by impairments in other cognitive domains and motor dysfunction. We aimed to develop, pilot, and test a novel visuocognitive prototype test battery which addressed these issues, suitable for both clinical and functional imaging use. Methods: We recruited 23 participants (14 with dementia, 6 of whom had extrapyramidal motor features, and 9 age-matched controls). The novel Newcastle visual perception prototype battery (NEVIP-B-Prototype) included angle, color, face, motion and form perception tasks, and an adapted response system. It allows for individualized task difficulties. Participants were tested outside and inside the 3T functional magnetic resonance imaging (fMRI) scanner. Functional magnetic resonance imaging data were analyzed using SPM8. Results: All participants successfully completed the task inside and outside the scanner. Functional magnetic resonance imaging analysis showed activation regions corresponding well to the regional specializations of the visual association cortex. In both groups, there was significant activity in the ventral occipital-temporal region in the face and color tasks, whereas the motion task activated the V5 region. In the control group, the angle task activated the occipitoparietal cortex. Patients and controls showed similar levels of activation, except on the angle task for which occipitoparietal activation was lower in patients than controls. Conclusion: Distinct visuoperceptual functions can be tested in patients with dementia and extrapyramidal motor features when tests use individualized thresholds, adapted tasks, and specialized response systems.

QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies

In 2003, the QUADAS tool for systematic reviews of diagnostic accuracy studies was developed. Experience, anecdotal reports, and feedback suggested areas for improvement; therefore, QUADAS-2 was developed. This tool comprises 4 domains: patient selection, index test, reference standard, and flow and timing. Each domain is assessed in terms of risk of bias, and the first 3 domains are also assessed in terms of concerns regarding applicability. Signalling questions are included to help judge risk of bias. The QUADAS-2 tool is applied in 4 phases: summarize the review question, tailor the tool and produce review-specific guidance, construct a flow diagram for the primary study, and judge bias and applicability. This tool will allow for more transparent rating of bias and applicability of primary diagnostic accuracy studies.

Factors influencing subjective quality of life in patients with schizophrenia and other mental disorders: a pooled analysis

Subjective quality of life (SQOL) is an important outcome in the treatment of patients with schizophrenia. However, there is only limited evidence on factors influencing SQOL, and little is known about whether the same factors influence SQOL in patients with schizophrenia and other mental disorders. This study aimed to identify the factors associated with SQOL and test whether these factors are equally important in schizophrenia and other disorders. For this we used a pooled data set obtained from 16 studies that had used either the Lancashire Quality of Life Profile or the Manchester Short Assessment of Quality of Life for assessing SQOL. The sample comprised 3936 patients with schizophrenia, mood disorders, and neurotic disorders. After controlling for confounding factors, within-subject clustering, and heterogeneity of findings across studies in linear mixed models, patients with schizophrenia had more favourable SQOL scores than those with mood and neurotic disorders. In all diagnostic groups, older patients, those in employment, and those with lower symptom scores had higher SQOL scores. Whilst the strength of the association between age and SQOL did not differ across diagnostic groups, symptom levels were more strongly associated with SQOL in neurotic than in mood disorders and schizophrenia. The association of employment and SQOL was stronger in mood and neurotic disorders than in schizophrenia. The findings may inform the use and interpretation of SQOL data for patients with schizophrenia.

The Permanent Income Hypothesis: A Test on Czech Privatisation

Since the late eighties, economists have been regarding the transition from command to market economies in Central and Eastern Europe with intense interest. In addition to studying the transition per se, they have begun using the region as a testing ground on which to investigate the validity of certain classic economic propositions. In his research, comprising three articles written in English and totalling 40 pages, Mr. Hanousek uses the so-called "Czech national experiment" (voucher privatisation scheme) to test the permanent income hypothesis (PIH). He took as his inspiration Kreinin's recommendation: "Since data concerning the behaviour of windfall income recipients is relatively scanty, and since such data can constitute an important test of the permanent income hypothesis, it is of interest to bring to bear on the hypothesis whatever information is available". Mr. Hanousek argues that, since the transfer of property to Czech citizens from 1992 to 1994 through the voucher scheme was not anticipated, it can be regarded as windfall income. The average size of the windfall was more than three month's salary and over 60 percent of the Czech population received this unexpected income. Furthermore, there are other reasons for conducting such an analysis in the Czech Republic. Firstly, the privatisation process took place quickly. Secondly, both the economy and consumer behaviour have been very stable. Thirdly, out of a total population of 10 million Czech citizens, an astonishing 6 million, that is, virtually every household, participated in the scheme. Thus Czech voucher privatisation provides a sample for testing the PIH almost equivalent to a full population, thus avoiding problems with the distribution of windfalls. Compare this, for instance with the fact that only 4% of the Israeli urban population received personal restitution from Germany, while the number of veterans who received the National Service Life Insurance Dividends amounted to less than 9% of the US population and were concentrated in certain age groups. But to begin with, Mr. Hanousek considers the question of whether the public percieves the transfer from the state to individual as an increase in net wealth. It can be argued that the state is only divesting itself of assets that would otherwise provide a future source of transfers. According to this argument, assigning these assets to individuals creates an offsetting change in the present value of potential future transfers so that individuals are no better off after the transfer. Mr. Hanousek disagrees with this approach. He points out that a change in the ownership of inefficient state-owned enterprises should lead to higher efficiency, which alone increases the value of enterprises and creates a windfall increase in citizens' portfolios. More importantly, the state and individuals had very different preferences during the transition. Despite government propaganda, it is doubtful that citizens of former communist countries viewed government-owned enterprises as being operated in the citizens' best interest. Moreover, it is unlikely that the public fully comprehended the sophisticated links between the state budget, state-owned enterprises, and transfers to individuals. Finally, the transfers were not equal across the population. Mr. Hanousek conducted a survey on 1263 individuals, dividing them into four monthly earnings categories. After determining whether the respondent had participated in the voucher process, he asked those who had how much of what they received from voucher privatisation had been (a) spent on goods and services, (b) invested elsewhere, (c) transferred to newly emerging pension funds, (d) given to a family member, and (e) retained in their original form as an investment. Both the mean and the variance of the windfall rise with income. He obtained similar results with respect to education, where the mean (median) windfall for those with a basic school education was 13,600 Czech Crowns (CZK), a figure that increased to 15,000 CZK for those with a high school education without exams, 19,900 CZK for high school graduates with exams, and 24,600 CZK for university graduates. Mr. Hanousek concludes that it can be argued that higher income (and better educated) groups allocated their vouchers or timed the disposition of their shares better. He turns next to an analysis of how respondents reported using their windfalls. The key result is that only a relatively small number of individuals reported spending on goods. Overall, the results provide strong support for the permanent income hypothesis, the only apparent deviation being the fact that both men and women aged 26 to 35 apparently consume more than they should if the windfall were annuitised. This finding is still fully consistent with the PIH, however, if this group is at a stage in their life-cycle where, without the windfall, they would be borrowing to finance consumption associated with family formation etc. Indeed, the PIH predicts that individuals who would otherwise borrow to finance consumption would consume the windfall up to the level equal to the annuitised fraction of the increase in lifetime income plus the full amount of the previously planned borrowing for consumption. Greater consumption would then be financed, not from investing the windfall, but from avoidance of future repayment obligations for debts that would have been incurred without the windfall.

Impact of Helicobacter pylori eradication on dyspepsia, health resource use, and quality of life in the Bristol helicobacter project: randomised controlled trial

OBJECTIVE: To determine the impact of a community based Helicobacter pylori screening and eradication programme on the incidence of dyspepsia, resource use, and quality of life, including a cost consequences analysis. DESIGN: H pylori screening programme followed by randomised placebo controlled trial of eradication. SETTING: Seven general practices in southwest England. PARTICIPANTS: 10,537 unselected people aged 20-59 years were screened for H pylori infection (13C urea breath test); 1558 of the 1636 participants who tested positive were randomised to H pylori eradication treatment or placebo, and 1539 (99%) were followed up for two years. INTERVENTION: Ranitidine bismuth citrate 400 mg and clarithromycin 500 mg twice daily for two weeks or placebo. MAIN OUTCOME MEASURES: Primary care consultation rates for dyspepsia (defined as epigastric pain) two years after randomisation, with secondary outcomes of dyspepsia symptoms, resource use, NHS costs, and quality of life. RESULTS: In the eradication group, 35% fewer participants consulted for dyspepsia over two years compared with the placebo group (55/787 v 78/771; odds ratio 0.65, 95% confidence interval 0.46 to 0.94; P = 0.021; number needed to treat 30) and 29% fewer participants had regular symptoms (odds ratio 0.71, 0.56 to 0.90; P = 0.05). NHS costs were 84.70 pounds sterling (74.90 pounds sterling to 93.91 pounds sterling) greater per participant in the eradication group over two years, of which 83.40 pounds sterling (146 dollars; 121 euro) was the cost of eradication treatment. No difference in quality of life existed between the two groups. CONCLUSIONS: Community screening and eradication of H pylori is feasible in the general population and led to significant reductions in the number of people who consulted for dyspepsia and had symptoms two years after treatment. These benefits have to be balanced against the costs of eradication treatment, so a targeted eradication strategy in dyspeptic patients may be preferable.

Swiss residents' speciality choices--impact of gender, personality traits, career motivation and life goals

BACKGROUND: The medical specialties chosen by doctors for their careers play an important part in the development of health-care services. This study aimed to investigate the influence of gender, personality traits, career motivation and life goal aspirations on the choice of medical specialty. METHODS: As part of a prospective cohort study of Swiss medical school graduates on career development, 522 fourth-year residents were asked in what specialty they wanted to qualify. They also assessed their career motivation and life goal aspirations. Data concerning personality traits such as sense of coherence, self-esteem, and gender role orientation were collected at the first assessment, four years earlier, in their final year of medical school. Data analyses were conducted by univariate and multivariate analyses of variance and covariance. RESULTS: In their fourth year of residency 439 (84.1%) participants had made their specialty choice. Of these, 45 (8.6%) subjects aspired to primary care, 126 (24.1%) to internal medicine, 68 (13.0%) to surgical specialties, 31 (5.9%) to gynaecology & obstetrics (G&O), 40 (7.7%) to anaesthesiology/intensive care, 44 (8.4%) to paediatrics, 25 (4.8%) to psychiatry and 60 (11.5%) to other specialties. Female residents tended to choose G&O, paediatrics, and anaesthesiology, males more often surgical specialties; the other specialties did not show gender-relevant differences of frequency distribution. Gender had the strongest significant influence on specialty choice, followed by career motivation, personality traits, and life goals. Multivariate analyses of covariance indicated that career motivation and life goals mediated the influence of personality on career choice. Personality traits were no longer significant after controlling for career motivation and life goals as covariates. The effect of gender remained significant after controlling for personality traits, career motivation and life goals. CONCLUSION: Gender had the greatest impact on specialty and career choice, but there were also two other relevant influencing factors, namely career motivation and life goals. Senior physicians mentoring junior physicians should pay special attention to these aspects. Motivational guidance throughout medical training should not only focus on the professional career but also consider the personal life goals of those being mentored.

Palliative in-patient cancer treatment in an anthroposophic hospital: II. Quality of life during and after stationary treatment, and subjective treatment benefits

BACKGROUND: There is an increasing demand for comprehensive forms of palliative cancer care, meeting physical as well as emotional, cognitive, spiritual and social needs. Therapy programs of anthroposophic hospitals are aimed at improving health and quality of life (QoL) at these levels. However, data on the influence of these programs on QoL of patients with advanced cancer are scarce. PATIENTS AND METHODS: 144 in-patients with advanced epithelial cancers were treated at the anthroposophic Lukas Klinik, Arlesheim, Switzerland. QoL was assessed upon admission, discharge and after 4 months, using 20 functional scales from the questionnaires EORTC QLQ-C30, HADS and SELT-M. Statistical testing was performed with the Wilcoxon signed rank test. At month 4, subjectively perceived benefits from anthroposophic medicine (AM) and conventional cancer therapy (CCT) were assessed by telephone. OBJECTIVE: The aim was to provide an account of global, physical, emotional, cognitive-spiritual and social QoL developments in advanced cancer patients, during and after in-patient AM treatment, and to investigate subjective benefits from AM and CCT. RESULTS: QoL improvements were observed in all 20 dimensions (12 significant). Compared to related studies, improvements were fairly high. At month 4, QoL scores had decreased but were still above baseline in all 20 dimensions. Both AM and CCT were perceived as beneficial. CONCLUSION: Our data provide evidence that in-patient therapy at an anthroposophic hospital can lead to significant QoL improvements, especially in emotional, but also global, physical, cognitive-spiritual and social aspects. Benefits of AM were experienced on the physical, emotional, cognitive- spiritual and social level. Benefits of CCT were tumor-focused.