Association between clinician factors and a patient's wish to hasten death: Terminally ill cancer patients and their doctors

This study investigated the clinical factors associated with a wish to hasten death among patients with advanced cancer receiving palliative care, with a focus on the role of clinician-related factors. Patients were grouped into high- and low-scoring groups on the basis of their wish to hasten death; doctor-patient pairs were formed. Questionnaire data collected from patients and their treating doctors were subjected to multivariate analysis. Significant predictors of a high wish to hasten death in terminally ill patients from among treating clinicians included the clinician's perception of the patient's lower optimism and greater emotional suffering, the patient indicating a wish to hasten death, the doctor willing to assist the patient in hastening death (if requested and legal), and the doctor reporting less training in psychotherapy. When these variables were combined with patient factors identified in a previous study, the model significantly predicted a wish to hasten death with the following variables patient factors: a higher perceived burden on others, higher depressive symptom scores, and lower family cohesion; physician factors: the doctor willing to assist the patient in hastening death (if requested and legal), the doctor's perception of lower levels of optimism and greater emotional distress in the patient, and the doctor having less training in psychotherapy; and the setting of care: recent admission to a hospice. The findings support the multifactorial influences on the wish to hasten death and suggest that the role of the clinician is a vital context within which the wish to hasten death should be considered.

Polymorphisms in the trace amine receptor 4 (TRAR4) gene on chromosome 6q23.2 are associated with susceptibility to schizophrenia

Several linkage studies across multiple population groups provide convergent support for a susceptibility locus for schizophrenia - and, more recently, for bipolar disorder - on chromosome 6q13-q26. We genotyped 192 European-ancestry and African American (AA) pedigrees with schizophrenia from samples that previously showed linkage evidence to 6q13-q26, focusing on the MOXD1-STX7-TRARs gene cluster at 6q23.2, which contains a number of prime candidate genes for schizophrenia. Thirty-one screening single-nucleotide polymorphisms (SNPs) were selected, providing a minimum coverage of at least 1 SNP/20 kb. The association observed with rs4305745 (P = .0014) within the TRAR4 (trace amine receptor 4) gene remained significant after correction for multiple testing. Evidence for association was proportionally stronger in the smaller AA sample. We performed database searches and sequenced genomic DNA in a 30-proband subsample to obtain a high-density map of 23 SNPs spanning 21.6 kb of this gene. Single-SNP analyses and also haplotype analyses revealed that rs4305745 and/or two other polymorphisms in perfect linkage disequilibrium (LD) with rs4305745 appear to be the most likely variants underlying the association of the TRAR4 region with schizophrenia. Comparative genomic analyses further revealed that rs4305745 and/or the associated polymorphisms in complete LD with rs4305745 could potentially affect gene expression. Moreover, RT-PCR studies of various human tissues, including brain, confirm that TRAR4 is preferentially expressed in those brain regions that have been implicated in the pathophysiology of schizophrenia. These data provide strong preliminary evidence that TRAR4 is a candidate gene for schizophrenia; replication is currently being attempted in additional clinical samples.

Approximating persistence in a general class of population processes

We provide a general framework for estimating persistence in populations which may be affected by catastrophic events, and which are either unbounded or have very large ceilings. We model the population using a birth-death process modified to allow for downward jumps of arbitrary size. For such processes, it is typically necessary to truncate the process in order to make the evaluation of expected extinction times (and higher-order moments) computationally feasible. Hence, we give particular attention to the selection of a cut-off point at which to truncate the process, and we present a simple method for obtaining quantitative indicators of the suitability of a chosen cut-off. (c) 2005 Elsevier Inc. All rights reserved.

The HIPASS catalogue - III. Optical counterparts and isolated dark galaxies

We present the largest catalogue to date of optical counterparts for H I radio-selected galaxies, HOPCAT. Of the 4315 H I radio-detected sources from the H I Parkes All Sky Survey (HIPASS) catalogue, we find optical counterparts for 3618 (84 per cent) galaxies. Of these, 1798 (42 per cent) have confirmed optical velocities and 848 (20 per cent) are single matches without confirmed velocities. Some galaxy matches are members of galaxy groups. From these multiple galaxy matches, 714 (16 per cent) have confirmed optical velocities and a further 258 (6 per cent) galaxies are without confirmed velocities. For 481 (11 per cent), multiple galaxies are present but no single optical counterpart can be chosen and 216 (5 per cent) have no obvious optical galaxy present. Most of these 'blank fields' are in crowded fields along the Galactic plane or have high extinctions. Isolated 'dark galaxy' candidates are investigated using an extinction cut of A(Bj) < 1 mag and the blank-fields category. Of the 3692 galaxies with an A(Bj) extinction < 1 mag, only 13 are also blank fields. Of these, 12 are eliminated either with follow-up Parkes observations or are in crowded fields. The remaining one has a low surface brightness optical counterpart. Hence, no isolated optically dark galaxies have been found within the limits of the HIPASS survey.

Porous functionalised silica particles: a potential platform for biomolecular screening

Novel, porous, functionalised silica particles have been developed with controlled morphology, which promote covalent attachment of fluorescent dyes which can act as an optical barcode.

Discovery of ultracompact dwarf galaxies in the Virgo Cluster

We have discovered nine ultracompact dwarf galaxies (UCDs) in the Virgo Cluster, extending samples of these objects outside the Fornax Cluster. Using the Two Degree Field (2dF) multifiber spectrograph on the Anglo-Australian Telescope, the new Virgo members were found among 1500 color-selected, starlike targets with 16: 0 < b(j) < 20.2 in a 2 degrees diameter field centered on M87 (NGC 4486). The newly found UCDs are comparable to the UCDs in the Fornax Cluster, with sizes less than or similar to 100 pc, -12.9 < M-B < -10.7, and exhibiting red absorption-line spectra, indicative of an older stellar population. The properties of these objects remain consistent with the tidal threshing model for the origin of UCDs from the surviving nuclei of nucleated dwarf elliptical galaxies disrupted in the cluster core but can also be explained as objects that were formed by mergers of star clusters created in galaxy interactions. The discovery that UCDs exist in Virgo shows that this galaxy type is probably a ubiquitous phenomenon in clusters of galaxies; coupled with their possible origin by tidal threshing, the UCD population is a potential indicator and probe of the formation history of a given cluster. We also describe one additional bright UCD with M-B = -12.0 in the core of the Fornax Cluster. We find no further UCDs in our Fornax Cluster Spectroscopic Survey down to bj 19.5 in two additional 2dF fields extending as far as 3 degrees from the center of the cluster. All six Fornax bright UCDs identified with 2dF lie within 0.degrees 5 (projected distance of 170 kpc) of the central elliptical galaxy NGC 1399.

Fractional Calculus of the Generalized Wright Function

Mathematics Subject Classification: 26A33, 33C20.

Új vektoriális betegségek megjelenésének lehetősége, és a már őshonos betegségek jelentőségének növekedése a klímaváltozás következtében. A XXI. század egészségügyi és hadászati biztonságát fenyegető hazardok

Az ízeltlábúak által terjesztett fertőző betegségek egyre emelkedő mértékben jelentenek majd veszélyt Európa mérsékelt övi lakosságának egészségi állapotára nézve. A klímaváltozás következtében meghosszabbodó vegetációs időszak, és az emelkedő átlaghőmérséklet a már jelen lévő betegség (Pl. Lyme), és számos, a lakosság számára új, meleg égövi betegség megtelepedését, vagy újra megjelenését okozhatja, mint amilyen például a leishmaniasis vagy a malária. A jövőben nem csak a civil lakosság egészségi állapotát, de a hadsereg személyi állományának egészségét és a hadműveletek biztonságát is veszélyeztethetik a vektoriális megbetegedések. _____ Emerging vectorial diseases threaten the population of the temperate areas of Europe. Due to climate change the increasing seasonal mean temperatures and the prolongation of the potential activity period of arthropod vectorial organisms will enhance the importance of the tick-borne diseases (eg. Lyme disease) and will facilitate the expansion of new or re-emerging vectorial diseases, such as leishmaniasis or malaria. These serious vectorial diseases can cause notable hazard not only for citizens but for the personnels and may endanger the safety of the operations, too.

The paradox of the binomial Ixodes ricinus activity and the observed unimodal Lyme borreliosis season in Hungary

The change of ambient temperature plays a key role in determining the run of the annual Lyme season. Our aim was to explain the apparent contradiction between the annual unimodal Lyme borreliosis incidence and the bimodal Ixodes ricinus tick activity run – both observed in Hungary – by distinguishing the temperaturedependent seasonal human and tick activity, the temperature-independent factors, and the multiplicative effect of human outdoor activity in summer holiday, using data from Hungary in the period of 1998–2012. This separation was verified by modeling the Lyme incidence based on the separated factors, and comparing the run of the observed and modeled incidence. We demonstrated the bimodality of tick season by using the originally unimodal Lyme incidence data. To model the outdoor human activity, the amount of camping guest nights was used, which showed an irregular run from mid-June to September. The human outdoor activity showed a similar exponential correlation with ambient temperature to that what the relative incidence did. It was proved that summer holiday has great influence on Lyme incidence.

Suffering Christ’s Call : Discipleship and the Cross

Peer reviewed

Duelo, ansiedad y depresión en familiares de pacientes en una unidad de cuidados paliativos a los dos meses de la pérdida

Aim: This study is going to assess the prevalance of prolonged grief diagnoses and it will evaluate the severity of the symptoms of depression, anxiety and complicated grief two months after a loved one is lost. We also intend to study which variables associated with the risk of grief could be more decisive when diagnosing it, its symptoms and the consequent emotional distress.Method: A total of 66 families of patients in the Palliative Care Unit (PCU) at Hospital San Cecilio in Granada have been evaluated. Measurements were taken two months after the death. This investigation has explored the existing emotional distress using the following questionnaires: Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Inventory of Complicated Grief (ICG) and Prolongued Grief Disorder (PG-12).Results: The results show that 33.3% and 21.21% of the sufferers had high levels of depression and clinical anxiety two months after the death. The prevalence of prolongued grief diagnoses, according to the PG-12, is 10.6% and 53.03% of the participants showed symptoms of complicated grief according to the ICG. Additionally, statistically significant differences are found in the sufferers with and without a prolongued grief diagnosis and scores in the ICG and BDI-II. The family’s financial situation is linked to the presence of symptoms of anxiety and depression and complicated grief, with the most determining variable being the risk of grief. Finally, the greater the age of the deceased and the longer the time spent in the PCU is linked to fewer symptoms of grief. However, important links have been found between the sufferers who have experienced stressful critical events prior to losing their loved one, with symptoms of depression, anxiety and complicated grief.Conclusions: The high numbers of cases of symptoms of complicated grief and levels of anxiety and clinical depression two months after a death suggests that early interventions should be carried out in those individuals with greater vulnerability.