Palmitate induces insulin resistance and a pro-atherogenic phenotype in monocytes

The present study investigated the effect of the two most abundant FFA in plasma – palmitate and oleate – on insulin sensitivity and vascular function (monocyte phenotype and adhesion to endothelium) using in vitro cell culture models and Wistar rats. Palmitate at 300µM for 6h induced insulin resistance in THP-1 monocytes and L6 monocytes. The ceramide synthesis pathway partly accounted for the palmitate-induced insulin resistance in THP-1 monocytes but not for L6 myotubes. Oleate treatment did not induce insulin resistance in either cell type and co-incubation with oleate protected cells from palmitate-induced insulin resistance. Palmitate at 300µN for 24h significantly increased cell surface CD11b and CD36 expression in U937 monocytes. The increase in CD11b and CD36 expression was effectively inhibited by Fumonisin B1, an inhibitor of ceramide synthesis. Oleate treatment did not show any effect on CD11b and CD36 expression and co-incubation with oleate antagonised the effect of palmitate on CD11b and CD36 expression in U937 monocytes. The increase in CD11b expression did not affect U937 monocyte adhesion to ICAM-1. Treating Wistar rats with palmitate for 6h caused a transient delay in glucose disposal and an increase in adhesion of U937 monocytes to the aortic endothelium, particularly at bifurcations. In conclusion, the present study demonstrates that the saturated free fatty acid palmitate induces insulin resistance and a pro-atherogenic phenotype for monocytes, whereas the unsaturated free fatty acid oleate does not. In vivo studies also confirmed that palmitate induces insulin resistance and an increase in monocyte adhesion to aorta.

Investigating the role of cholesterol in the formation of non-ionic surfactant based bilayer vesicles:thermal analysis and molecular dynamics

The aim of this research was to investigate the molecular interactions occurring in the formulation of non-ionic surfactant based vesicles composed monopalmitoyl glycerol (MPG), cholesterol (Chol) and dicetyl phosphate (DCP). In the formulation of these vesicles, the thermodynamic attributes and surfactant interactions based on molecular dynamics, Langmuir monolayer studies, differential scanning calorimetry (DSC), hot stage microscopy and thermogravimetric analysis (TGA) were investigated. Initially the melting points of the components individually, and combined at a 5:4:1 MPG:Chol:DCP weight ratio, were investigated; the results show that lower (90 C) than previously reported (120-140 C) temperatures could be adopted to produce molten surfactants for the production of niosomes. This was advantageous for surfactant stability; whilst TGA studies show that the individual components were stable to above 200 C, the 5:4:1 MPG:Chol:DCP mixture show ∼2% surfactant degradation at 140 C, compared to 0.01% was measured at 90 C. Niosomes formed at this lower temperature offered comparable characteristics to vesicles prepared using higher temperatures commonly reported in literature. In the formation of niosome vesicles, cholesterol also played a key role. Langmuir monolayer studies demonstrated that intercalation of cholesterol in the monolayer did not occur in the MPG:Chol:DCP (5:4:1 weight ratio) mixture. This suggests cholesterol may support bilayer assembly, with molecular simulation studies also demonstrating that vesicles cannot be built without the addition of cholesterol, with higher concentrations of cholesterol (5:4:1 vs 5:2:1, MPG:Chol:DCP) decreasing the time required for niosome assembly. © 2013 Elsevier B.V.

Multiple component patient safety intervention in English hospitals:controlled evaluation of second phase

Objective: To independently evaluate the impact of the second phase of the Health Foundation's Safer Patients Initiative (SPI2) on a range of patient safety measures. Design: A controlled before and after design. Five substudies: survey of staff attitudes; review of case notes from high risk (respiratory) patients in medical wards; review of case notes from surgical patients; indirect evaluation of hand hygiene by measuring hospital use of handwashing materials; measurement of outcomes (adverse events, mortality among high risk patients admitted to medical wards, patients' satisfaction, mortality in intensive care, rates of hospital acquired infection). Setting: NHS hospitals in England. Participants: Nine hospitals participating in SPI2 and nine matched control hospitals. Intervention The SPI2 intervention was similar to the SPI1, with somewhat modified goals, a slightly longer intervention period, and a smaller budget per hospital. Results: One of the scores (organisational climate) showed a significant (P=0.009) difference in rate of change over time, which favoured the control hospitals, though the difference was only 0.07 points on a five point scale. Results of the explicit case note reviews of high risk medical patients showed that certain practices improved over time in both control and SPI2 hospitals (and none deteriorated), but there were no significant differences between control and SPI2 hospitals. Monitoring of vital signs improved across control and SPI2 sites. This temporal effect was significant for monitoring the respiratory rate at both the six hour (adjusted odds ratio 2.1, 99% confidence interval 1.0 to 4.3; P=0.010) and 12 hour (2.4, 1.1 to 5.0; P=0.002) periods after admission. There was no significant effect of SPI for any of the measures of vital signs. Use of a recommended system for scoring the severity of pneumonia improved from 1.9% (1/52) to 21.4% (12/56) of control and from 2.0% (1/50) to 41.7% (25/60) of SPI2 patients. This temporal change was significant (7.3, 1.4 to 37.7; P=0.002), but the difference in difference was not significant (2.1, 0.4 to 11.1; P=0.236). There were no notable or significant changes in the pattern of prescribing errors, either over time or between control and SPI2 hospitals. Two items of medical history taking (exercise tolerance and occupation) showed significant improvement over time, across both control and SPI2 hospitals, but no additional SPI2 effect. The holistic review showed no significant changes in error rates either over time or between control and SPI2 hospitals. The explicit case note review of perioperative care showed that adherence rates for two of the four perioperative standards targeted by SPI2 were already good at baseline, exceeding 94% for antibiotic prophylaxis and 98% for deep vein thrombosis prophylaxis. Intraoperative monitoring of temperature improved over time in both groups, but this was not significant (1.8, 0.4 to 7.6; P=0.279), and there were no additional effects of SPI2. A dramatic rise in consumption of soap and alcohol hand rub was similar in control and SPI2 hospitals (P=0.760 and P=0.889, respectively), as was the corresponding decrease in rates of Clostridium difficile and meticillin resistant Staphylococcus aureus infection (P=0.652 and P=0.693, respectively). Mortality rates of medical patients included in the case note reviews in control hospitals increased from 17.3% (42/243) to 21.4% (24/112), while in SPI2 hospitals they fell from 10.3% (24/233) to 6.1% (7/114) (P=0.043). Fewer than 8% of deaths were classed as avoidable; changes in proportions could not explain the divergence of overall death rates between control and SPI2 hospitals. There was no significant difference in the rate of change in mortality in intensive care. Patients' satisfaction improved in both control and SPI2 hospitals on all dimensions, but again there were no significant changes between the two groups of hospitals. Conclusions: Many aspects of care are already good or improving across the NHS in England, suggesting considerable improvements in quality across the board. These improvements are probably due to contemporaneous policy activities relating to patient safety, including those with features similar to the SPI, and the emergence of professional consensus on some clinical processes. This phenomenon might have attenuated the incremental effect of the SPI, making it difficult to detect. Alternatively, the full impact of the SPI might be observable only in the longer term. The conclusion of this study could have been different if concurrent controls had not been used.

Identifications with an ‘aesthetic’ and ‘moral’ diaspora amongst Tamils of diverse state origins in Britain

This chapter employs Pnina Werbner's notion of diasporas as moral communities of suffering and co-responsibility, as well as aesthetic communities of shared transnational consumption of culture and performance of ritual, and relates this to the case of Tamil migrants of diverse state origins in Britain. Sri Lankan Tamil migrants I interviewed towards my research imagine membership of a Tamil diaspora as based on personal (or familial) experiences of suffering in the Sri Lankan civil war, which acts both to create bonds with other Sri Lankan Tamils, and to distinguish from Tamils of other state origins (Indian, Singaporean etc.) despite cultural commonalities (Werbner's aesthetic diaspora). Conversely, many of the non-Sri Lankan Tamil migrants I interviewed imagined these boundaries in more flexible terms, and claimed membership of the 'community of suffering' in ways which did not necessitate personal experience, but rather privileged symbolic constructions of the ethnic community, and an interpretation of historical and current events in India, Sri Lanka (and other sites of Tamil population) as components of a single narrative of Tamil victimhood.

Being Tamil, being Hindu:Tamil migrants’ negotiations of the absence of Tamil Hindu spaces in the West Midlands and South West of England

This paper considers the religious practices of Tamil Hindus who have settled in the West Midlands and South West of England in order to explore how devotees of a specific ethno-regional Hindu tradition with a well-established UK infrastructure in the site of its adherents’ population density adapt their religious practices in settlement areas which lack this infrastructure. Unlike the majority of the UK Tamil population who live in the London area, the participants in this study did not have ready access to an ethno-religious infrastructure of Tamil-orientated temples and public rituals. The paper examines two means by which this absence was addressed as well as the intersections and negotiations of religion and ethnicity these entailed: firstly, Tamil Hindus’ attendance of temples in their local area which are orientated towards a broadly imagined Hindu constituency or which cater to a non-Tamil ethno-linguistic or sectarian community; and, secondly, through the ‘DIY’ performance of ethnicised Hindu ritual in non-institutional settings.

Estimation of computer waste quantities using forecasting techniques

Technology changes rapidly over years providing continuously more options for computer alternatives and making life easier for economic, intra-relation or any other transactions. However, the introduction of new technology “pushes” old Information and Communication Technology (ICT) products to non-use. E-waste is defined as the quantities of ICT products which are not in use and is bivariate function of the sold quantities, and the probability that specific computers quantity will be regarded as obsolete. In this paper, an e-waste generation model is presented, which is applied to the following regions: Western and Eastern Europe, Asia/Pacific, Japan/Australia/New Zealand, North and South America. Furthermore, cumulative computer sales were retrieved for selected countries of the regions so as to compute obsolete computer quantities. In order to provide robust results for the forecasted quantities, a selection of forecasting models, namely (i) Bass, (ii) Gompertz, (iii) Logistic, (iv) Trend model, (v) Level model, (vi) AutoRegressive Moving Average (ARMA), and (vii) Exponential Smoothing were applied, depicting for each country that model which would provide better results in terms of minimum error indices (Mean Absolute Error and Mean Square Error) for the in-sample estimation. As new technology does not diffuse in all the regions of the world with the same speed due to different socio-economic factors, the lifespan distribution, which provides the probability of a certain quantity of computers to be considered as obsolete, is not adequately modeled in the literature. The time horizon for the forecasted quantities is 2014-2030, while the results show a very sharp increase in the USA and United Kingdom, due to the fact of decreasing computer lifespan and increasing sales.

Effects of two intervention strategies on the behavior of nurses and nurse students related to advance directives

Advance directives are one mechanism for preserving the rights of individuals to exercise some control over their health care when serious illness may prevent them from direct participation. Nurses, as the health care providers with the closest and most sustained contact with critically ill and dying patients, are positioned to assist patients to plan for future health care needs. Although a majority of nurses favor the concept of advance directives for their patients and for themselves, they have not played a significant role in facilitating advance health care planning with their patients nor implemented advance health care planning for themselves.^ Research has also shown that differing forms of education and counseling increase the completion rates for advance directives in selected populations, mostly the elderly and seriously ill. Not yet developed are effective educational strategies to assist nurses and nurse students to make optimal contributions in assisting their clients' plans for future health care decision-making. This study sought to determine whether specific learning strategies (a) increased the involvement of nurses and nurse students in facilitating advance care planning with patients and (b) increased the percentage of the nurses' and nurse students' own personal advance care planning activities.^ The study compared two learning interventions and two populations, nurses and nurse students. The participants were randomly assigned to one of the two learning interventions, L1 or L2. Participants in L1 received a lecture, discussion and exploration of the forces impacting on advance directive behavior. Participants in L2 received the same intervention components with the additional component of group practice completing advance directives.^ Analysis of the data by chi-square and logistic regression did not support the hypotheses that the practice component would make a difference in the participants' facilitation of advance care planning with patients or in their own personal advance care planning activities. There were significant differences in post-intervention behavior between the nurse and nurse student groups. The nurses in the study did significantly more facilitation of advance care planning with patients and completed significantly more advance care documents than the nurse students post-intervention. However, the nurse students held more post-intervention family discussions than did the nurses. ^

Effect of an inservice on the teachers' knowledge of general school law, Section 504, and the Meta Consent Decree

It is generally assumed by educators that inservice training will make a significant difference in teacher knowledge of topics related to education. This investigation addressed that assumption by examining the effects of various factors, e.g., amount and timing of inservice training, upon teacher knowledge of educational law. Of special interest was teacher knowledge of the law as it pertained to ethnic and other characteristics of students in urban school settings. This study was deliberately designed to determine which factors should be later investigated in a more deterministic form, e.g., an experimental design.^ The investigation built upon that of Ogletree (1985), Osborne (1996) and others who focused on the importance of teacher development as a method to enhance professional abilities. The main question addressed in this study was, "How knowledgeable are teachers of school law, especially with regard to general school law, the Meta Consent Decree and Section 504 of the Rehabilitation Act of 1973."^ The study participants (N = 302) were from the Dade County School System, the fourth largest in the U.S. The survey design (approved by the System), specified participants from all levels and types of schools and geographic representations. A survey instrument was created, pilot tested, revised and approved for use by the district official representatives. After administration of the instrument, the resultant data was treated by several appropriate tests, e.g., multivariate analysis of variance (ANOVA).^ Several findings emerged from the analysis of the data: in general, teachers did not have sufficient knowledge of school law; factors, such as amount and level of education, and status and position were positively correlated with increased knowledge; factors such as years of experience, gender, race and ethnicity were not correlated with higher levels of knowledge. The most significant, however, was that when teachers had participated in several inservice training experiences, typically workshops, and, when combined with other factors noted above, their knowledge of school law was significantly higher. Specific recommendations for future studies were made. ^

Facing a paradigm shift in professional credentialing: Preparedness of registered dietitians for Professional Development 2001

In the year 2001, the Commission on Dietetic Registration (CDR) will begin a new process of recertifying Registered Dietitians (RD) using a self-directed lifelong learning portfolio model. The model, entitled Professional Development 2001 (PD 2001), is designed to increase competency through targeted learning. This portfolio consists of five steps: reflection, learning needs assessment, formulation of a learning plan, maintenance of a learning log, and evaluation of the learning plan. By targeting learning, PD 2001 is predicted to foster more up-to-date practitioners than the current method that requires only a quantity of continuing education hours. This is the first major change in the credentialing system since 1975. The success or failure of the new system will impact the future of approximately 60,000 practitioners. The purpose of this study was to determine the readiness of RDs to change to the new system. Since the model is dependent on setting goals and developing learning plans, this study examined the methods dietitians use to determine their five-year goals and direction in practice. It also determined RD's attitudes towards PD 2001 and identified some of the factors that influenced their beliefs. A dual methodological design using focus groups and questionnaires was utilized. Sixteen focus groups were held during state dietetic association meetings. Demographic data was collected on the 132 registered dietitians who participated in the focus groups using a self-administered questionnaire. The audiotaped sessions were transcribed into 643 pages of text and analyzed using Non-numerical Unstructured Data - Indexing Searching and Theorizing (NUD*IST version 4). Thirty-four of the 132 participants (26%) had formal five-year goals. Fifty-four participants (41%) performed annual self-assessments. In general, dietitians did not currently have professional goals nor conduct self-assessments and they claimed they did not have the skills or confidence to perform these tasks. Major barriers to successful implementation of PD 2001 are uncertainty, misinterpretation, and misinformation about the process and purpose, which in turn contribute to negative impressions. Renewed vigor to provide a positive, accurate message along with presenting goal-setting strategies will be necessary for better acceptance of this professional development process. ^

Ethnic groups and institutions: A study of institutional engineering in four Central and Eastern European countries

The issue of institutional engineering has gained a renewed interest with the democratic transitions of the Central and Eastern European countries, as for some states it has become a matter of state survival. The four countries examined in the study – Macedonia, Slovakia, Romania and Bulgaria – exemplify the difficulty in establishing a stable democratic society in the context of the resurgence of national identity. The success of ethnonational minorities in achieving the desired policies affirming or expanding their rights as a group was conditioned upon the cohesion of the minority as well as the permissiveness of state institutions in terms of participation and representation of minority members. The Hungarian minorities in Slovakia and Romania, the Turkish minority in Bulgaria, and the Albanian minority in Macedonia, formed their political organizations to represent their interests. However, in some cases the divergence of strategies or goals between factions of the minority group seriously impeded its ability to obtain the desired concessions from the majority. The difficulty in the pursuit of policies favoring the expansion of minority rights was further exacerbated in some of the cases by the impermissiveness of political institutions. The political parties representing the interest of ethnonational minorities were allowed to participate in elections, although not without suspicions about their intent and even strong opposition from majority groups, but participation in elections and subsequent representation in legislative bodies did not translate into adoption of the desired policies. The ethnonational minorities' inability to effectively influence the decision-making process was the result of the inadequacy of democratic institutions to process these demands and channel them through the normal political process in the absence of majority desire to accommodate them. Despite the promise of democratic institutions to bring about a major overhaul of the policies of forceful assimilation and disregard for minority rights, the four cases analyzed in the study demonstrate that in effect ethnonational minorities continued to be at the mercy of the majority, especially if the minority was unable to position itself as a balancing actor.

Color-based surface reflectance separation for scene illumination estimation and rendering

Given the importance of color processing in computer vision and computer graphics, estimating and rendering illumination spectral reflectance of image scenes is important to advance the capability of a large class of applications such as scene reconstruction, rendering, surface segmentation, object recognition, and reflectance estimation. Consequently, this dissertation proposes effective methods for reflection components separation and rendering in single scene images. Based on the dichromatic reflectance model, a novel decomposition technique, named the Mean-Shift Decomposition (MSD) method, is introduced to separate the specular from diffuse reflectance components. This technique provides a direct access to surface shape information through diffuse shading pixel isolation. More importantly, this process does not require any local color segmentation process, which differs from the traditional methods that operate by aggregating color information along each image plane. ^ Exploiting the merits of the MSD method, a scene illumination rendering technique is designed to estimate the relative contributing specular reflectance attributes of a scene image. The image feature subset targeted provides a direct access to the surface illumination information, while a newly introduced efficient rendering method reshapes the dynamic range distribution of the specular reflectance components over each image color channel. This image enhancement technique renders the scene illumination reflection effectively without altering the scene’s surface diffuse attributes contributing to realistic rendering effects. ^ As an ancillary contribution, an effective color constancy algorithm based on the dichromatic reflectance model was also developed. This algorithm selects image highlights in order to extract the prominent surface reflectance that reproduces the exact illumination chromaticity. This evaluation is presented using a novel voting scheme technique based on histogram analysis. ^ In each of the three main contributions, empirical evaluations were performed on synthetic and real-world image scenes taken from three different color image datasets. The experimental results show over 90% accuracy in illumination estimation contributing to near real world illumination rendering effects. ^

The epidemiology of prostate cancer among multiethnic men

The research goal was to document differences in the epidemiology of prostate cancer among multicultural men [non-Hispanic White (NHW), Hispanic (H), non-Hispanic Black (NHB)], and Black subgroups, particularly among NHB subgroups [US-born (USB) and Caribbean-born (CBB)]. Study findings will be useful in supporting further research into Black subgroups. Aim 1 explored changes over time in reported prostate cancer prevalence, by race/ethnicity and by birthplace (within the Black subgroups). Aim 2 investigated relationships between observed and latent variables. The analytical approaches included confirmatory factor analysis (CFA for measurement models) and structural equation modeling (SEM for regression models). National Center for Health Statistics, National Health Interview Survey (NHIS) data from 1999–2008 were used. The study sample included men aged 18 and older, grouped by race/ethnicity. Among the CBB group, survey respondents were limited to the English-speaking Caribbean. Prostate cancer prevalence, by race showed a higher trend among NHB men than NHW men overall, however differences over time were not significant. CBB men reported a higher proportion of prostate cancer among cancers diagnosed than USB men overall. Due to small sample sizes, stable prostate cancer prevalence trends could not be assessed over time nor could trends in the receipt of a PSA exam among NHB men when stratified by birthplace. USB and CBB men differ significantly in their screening behavior. The effect of SES on PSA screening adjusted for risk factors was statistically significant while latent variable lifestyle was not. Among risk factors, family history of cancer exhibited a consistent positive effect on PSA screening for both USB and CBB men. Among the CBB men, the number of years lived in the US did not significantly affect PSA screening behavior. When NHB men are stratified by birthplace, CBB men had a higher overall prevalence of prostate cancer diagnoses than USB men although not statistically significant. USB men were 2 to 3 times more likely to have had a PSA exam compared to CBB men, but among CBB men birthplace did not make a significant difference in screening behavior. Latent variable SES, but not lifestyle, significantly affected the likelihood of a PSA exam.

Teachers' experiences in and perceptions of their 12th-grade British literature classrooms

The purpose of this study was to understand the experiences and perceptions of 12th-grade literature teachers about curriculum, Post-Colonial literature, and students. Theories posed by Piaget (1995), Vygotsky (1995), and Rosenblatt (1995) formed the framework for this micro-ethnographic study. Seven teachers from public and private schools in South Florida participated in this two-phase study; three teachers in Phase I and four in Phase II. All participants completed individual semi-structured interviews and demographic surveys. In addition, four of the teachers were observed teaching. The analysis yielded three themes and two sub-themes: (a) knowledge concerned teachers' knowledge of British literature content and Post-Colonial authors and their literature; (b) freedom described teachers' freedom to choose how to teach their content. Included in this theme was dilemmas associated with 12th-grade classrooms which described issues that were pertinent to the 12th-grade teacher and classroom that were revealed by the study; and (c) thoughts about students described teachers' perceptions about students and how literature might affect the students. Two subthemes of knowledge were as follows:(1) text complexity described teacher responses to a Post-Colonial text's complexity and (2) student desirability/teachability described teachers' perception about how desirable Post-Colonial texts would be to students and whether teachers would be willing to teach these texts. The researcher offers recommendations for understanding factors associated with 12th-grade teachers perceptions and implications for enhancing the 12th-grade experience for teachers and curriculum, based on this study: (a) build teacher morale and capacity, (b) treat all students as integral components of the teaching and learning process; teachers in this study thought teaching disenfranchised learners was a form of punishment meted out by the administration, and (c) include more Post-Colonial authors in school curricula in colleges and schools as most teachers in this study did not study this type of literature nor knew how to teach it.

Infant feeding practices of Cuban mothers residing in Dade County, Florida

Research has shown that infant feeding practices differ between cultures. A convenience sample of 51 first generation Cuban mothers with infants birth to 12 months of age were surveyed to identify their infant feeding practices, and why they introduce foods to their infants in the manner in which they do. Data obtained from the mothers' responses to an English/Spanish Questionnaire were summarized by frequencies. Findings revealed that Cuban mothers consider a variety of foods from the major four food groups to be suitable for their infants. They introduced solids to their infants at the average age of four months and fed their infants in the manner in which they did because they thought it was healthy/nutritious. Cuban mothers may feed their infants as taught by health care professionals if their infant feeding practices are incorporated in the culture specific infant feeding programmes developed by the health team.

Three essays on the economics of defense contracting, output and income inequality

This dissertation analyzes both the economics of the defense contracting process and the impact of total dollar obligations on the economies of U.S. states. Using various econometric techniques, I will estimate relationships across individual contracts, state level output, and income inequality. I will achieve this primarily through the use of a dataset on individual contract obligations. ^ The first essay will catalog the distribution of contracts and isolate aspects of the process that contribute to contract dollar obligations. Accordingly, this study describes several characteristics about individual defense contracts, from 1966-2006: (i) the distribution of contract dollar obligations is extremely rightward skewed, (ii) contracts are unevenly distributed in a geographic sense across the United States, (iii) increased duration of a contract by 10 percent is associated with an increase in costs by 4 percent, (iv) competition does not seem to affect dollar obligations in a substantial way, (v) contract pre-payment financing increases the obligation of contracts from anywhere from 62 to 380 percent over non-financed contracts. ^ The second essay will turn to an aggregate focus, and look the impact of defense spending on state economic output. The analysis in chapter two attempts to estimate the state level fiscal multiplier, deploying Difference-in-Differences estimation as an attempt to filter out potential endogeneity bias. Interstate variation in procurement spending facilitates utilization of a natural experiment scenario, focusing on the spike in relative spending in 1982. The state level relative multiplier estimate here is 1.19, and captures the short run, impact effect of the 1982 spending spike. ^ Finally I will look at the relationship between defense contracting and income inequality. Military spending has typically been observed to have a negative relationship with income inequality. The third chapter examines the existence of this relationship, combining data on defense procurement with data on income inequality at the state level, in a longitudinal analysis across the United States. While the estimates do not suggest a significant relationship exists for the income share of the top ten percent of households, there is a significant positive relationship for the income share of top one percent households for an increase in defense procurement.^