Physicians' attitudes towards end-of-life decisions: a comparison between seven countries

In the context of an European collaborative research project (EURELD), a study on attitudes towards medical end-of-life decisions was conducted among physicians in Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Australia also joined the consortium. A written questionnaire with structured questions was sent to practising physicians from specialties frequently involved in the care of dying patients. 10,139 questionnaires were studied. Response rate was equal to or larger than 50% in all countries except Italy (39%). Apart from general agreement with respect to the alleviation of pain and symptoms with possible life-shortening effect, there was large variation in support-between and within countries-for medical decision that may result in the hastening of death. A principal component factor analysis found that 58% of the variance of the responses is explained by four factors. 'Country' explained the largest part of the variation of the standardized factor scores. (c) 2004 Elsevier Ltd. All rights reserved.

Effective knowledge transfer: a terminological perspective - Dismantling the jargon barrier to knowledge about computer security

The research is concerned with the terminological problems that computer users experience when they try to formulate their knowledge needs and attempt to access information contained in computer manuals or online help systems while building up their knowledge. This is the recognised but unresolved problem of communication between the specialist and the layman. The initial hypothesis was that computer users, through their knowledge of language, have some prior knowledge of the subdomain of computing they are trying to come to terms with, and that language can be a facilitating mechanism, or an obstacle, in the development of that knowledge. Related to this is the supposition that users have a conceptual apparatus based on both theoretical knowledge and experience of the world, and of several domains of special reference related to the environment in which they operate. The theoretical argument was developed by exploring the relationship between knowledge and language, and considering the efficacy of terms as agents of special subject knowledge representation. Having charted in a systematic way the territory of knowledge sources and types, we were able to establish that there are many aspects of knowledge which cannot be represented by terms. This submission is important, as it leads to the realisation that significant elements of knowledge are being disregarded in retrieval systems because they are normally expressed by language elements which do not enjoy the status of terms. Furthermore, we introduced the notion of `linguistic ease of retrieval' as a challenge to more conventional thinking which focuses on retrieval results.

Defective peroxisomal proliferators activated receptor gamma activity due to dominant-negative mutation synergizes with hypertension to accelerate cardiac fibrosis in mice

Aims: Humans with inactivating mutations in peroxisomal proliferators activated receptor gamma (PPAR?) typically develop a complex metabolic syndrome characterized by insulin resistance, diabetes, lipodystrophy, hypertension, and dyslipidaemia which is likely to increase their cardiovascular risk. Despite evidence that the activation of PPAR? may prevent cardiac fibrosis and hypertrophy, recent evidence has suggested that pharmacological activation of PPAR? causes increased cardiovascular mortality. In this study, we investigated the effects of defective PPAR? function on the development of cardiac fibrosis and hypertrophy in a murine model carrying a human dominant-negative mutation in PPAR?. Methods and results: Mice with a dominant-negative point mutation in PPAR? (P465L) and their wild-type (WT) littermates were treated with either subcutaneous angiotensin II (AngII) infusion or saline for 2 weeks. Heterozygous P465L and WT mice developed a similar increase in systolic blood pressure, but the mutant mice developed significantly more severe cardiac fibrosis to AngII that correlated with increased expression of profibrotic genes. Both groups similarly increased the heart weight to body weight ratio compared with saline-treated controls. There were no differences in fibrosis between saline-treated WT and P465L mice. Conclusion: These results show synergistic pathogenic effects between the presence of defective PPAR? and AngII-induced hypertension and suggest that patients with PPAR? mutation and hypertension may need more aggressive therapeutic measures to reduce the risk of accelerated cardiac fibrosis. © The Author 2009.

Role of transglutaminase 1 in stabilisation of intercellular junctions of the vascular endothelium

Microvascular endothelial monolayers from mouse myocardium (MyEnd) cultured for up to 5 days postconfluency became increasingly resistant to various barrier-compromising stimuli such as low extracellular Ca2+ and treatment with the Ca2+ ionophore A23187 and with the actin depolymerising compound cytochalasin D. In contrast, microvascular endothelial monolayers from mouse lung microvessels (PulmEnd) remained sensitive to these conditions during the entire culture period which corresponds to the well-known in vivo sensitivity of the lung microvasculature to Ca2+depletion and cytochalasin D treatment. One molecular difference between pulmonary and myocardial endothelial cells was found to be transglutaminase 1 (TGase1) which is strongly expressed in myocardial endothelial cells but is absent from pulmonary endothelial cells. Resistance of MyEnd cells to barrier-breaking conditions correlated strongly with translocation of TGase1 to intercellular junctions. Simultaneous inhibition of intracellular and extracellular TGase activity by monodansylcadaverine (MDC) strongly weakened barrier properties of MyEnd monolayers, whereas inhibition of extracellular TGases by the membrane-impermeable active site-directed TGase inhibitor R281 did not reduce barrier properties. Weakening of barrier properties could be also induced in MyEnd cells by downregulation of TGase1 expression using RNAi-based gene silencing. These findings suggest that crosslinking activity of intracellular TGase1 at intercellular junctions may play a role in controlling barrier properties of endothelial monolayers.

The effect of the advanced placement examination for credit policy by the Florida State universities on the acceleration of a student's postsecondary education

The purpose of this research study was to determine if the Advanced Placement program as it is recognized by the universities in the Florida State University System (SUS) truly serves as an acceleration mechanism for those students who enter an SUS institution with passing AP scores. Despite mandates which attempt to control uniformity of policy, each public university in Florida determines which courses will be exempted and the number of credits they will grant for passing Advanced Placement courses.^ This is a descriptive study in which the AP policies of each of the SUS institutions were compared. Additionally, the college attendance and graduation data on members of a cohort of 593 Broward County high school graduates of the class of June, 1992 were compared. Approximately 28% of the cohort members entered university with passing Advanced Placement scores.^ The rate of early and on time graduation was significantly dependent on the Advanced Placement standing of the students in the cohort. Given the financial and human cost involved, it is recommended that all state universities bring their Advanced Placement policies into line with each other and implement a uniform Advanced Placement policy. It is also recommended that a follow-up study be conducted with a new cohort bound under the current 120 credit limitation for graduation. ^

Club Ratios: A Four-Year Trend Analysis

This article is based on research of the United States club industry conducted over the four-year period of 2003-2006. Twenty ratios were reported, covering the five general classes of financial ratios. The ratio results suggested that 2003 was a banner year for the club industry.

Job Satisfaction of Club Financial Executives

Studying the job satisfaction of financial management personnel in the club industry may offer additional information to management of clubs to better work with and retain their associates. It is also hoped that the results of this study will provide hospitality students aspiring to become financial management personnel in the club industry with a glimpse of the job satisfaction level of financial executives in the club industry

Satisfaction: Is Money Everything?

When people are asked whether they are satisfied with their jobs or careers, the first item that comes to mind, most of the time, is money. Then other factors such as advancement, work hours, autonomy, flexibility, etc. are soon added to the total equation. In this study, 140 financial and technology professionals in the lodging industry shared their satisfaction level and perceived importance of carious attributes of their career.

Private Club Financial Performance

This article reveals the median financial results for the club industry for 2011 using 24 financial ratios. The results are based on the submission of balance sheet and selected income statement numbers from 80 clubs. The ratios are reported as median results for the entire sample as well as the median results for the top and low performing clubs delineated by return on assets. The biggest differences between the two extreme groups of clubs are (1) average collection period, (2) operating cash flows to current liabilities and long-term debt, (3) fines interest earned, (4) fixed charge coverage ratio, (5) food and beverage inventory turnovers, (6) profit margin, (7) return on assets, (8) operating efficiency ratio, (9) labor cost percentage.

Age determination of sediment cores of the Golf of Lions

Siliciclastic turbidites represent huge volumes of sediments, which are of particular significance for (1) petroleum researchers, interested in their potential as oil reservoirs and (2) sedimentologists, who aim at understanding sediment transport processes from continent to deep-basins. An important challenge when studying marine turbidites has been to establish a reliable chronology for the deposits. Indeed, conventional marine proxies applied to hemipelagic sediments are often unreliable in detrital clays. In siliciclastic turbidites, those proxies can be used only in hemipelagic intervals, providing a poor constraint on their chronology. In this study, we have used sediments from the Rhône Neofan (NW Mediterranean Sea) to demonstrate that pollen grains can provide a high-resolution chronostratigraphical framework for detrital clays in turbidites. Vegetation changes occurring from the end of Marine Isotopic Stage 3 to the end of Marine Isotopic Stage 2 (from ~30 to ~18 ka cal. BP) are clearly recorded where other proxies have failed previously, mainly because the scarcity of foraminifers in these sediments prevented any continuous Sea Surface Temperature (SST) record and radiocarbon dating to be obtained. We show also that the use of palynology in turbidite deposits is able to contribute to oceanographical and sedimentological purposes: (1) Pinus pollen grains can document the timing of sea-level rise, (2) the ratio between pollen grains transported from the continent via rivers and dinoflagellate cysts (elutriating) allows us to distinguish clearly detrital sediments from pelagic clays. Finally, taken together, all these tools show evidence that the Rhône River disconnected from the canyon during the sea-level rise and thus evidence the subsequent rapid starvation of the neofan at 18.5 ka cal. BP. Younger sediments are hemipelagic: the frequency of foraminifers allowed to date sediments with radiocarbon. First results of Sea Surface Temperature obtained on foraminifers are in good agreement with the dinoflagellate cysts climatic signal. Both provide information on the end of the deglaciation and the Holocene.

Data compilation on the biological response to ocean acidification: environmental and experimental context of data sets and related literature

The exponential growth of studies on the biological response to ocean acidification over the last few decades has generated a large amount of data. To facilitate data comparison, a data compilation hosted at the data publisher PANGAEA was initiated in 2008 and is updated on a regular basis (doi:10.1594/PANGAEA.149999). By January 2015, a total of 581 data sets (over 4 000 000 data points) from 539 papers had been archived. Here we present the developments of this data compilation five years since its first description by Nisumaa et al. (2010). Most of study sites from which data archived are still in the Northern Hemisphere and the number of archived data from studies from the Southern Hemisphere and polar oceans are still relatively low. Data from 60 studies that investigated the response of a mix of organisms or natural communities were all added after 2010, indicating a welcomed shift from the study of individual organisms to communities and ecosystems. The initial imbalance of considerably more data archived on calcification and primary production than on other processes has improved. There is also a clear tendency towards more data archived from multifactorial studies after 2010. For easier and more effective access to ocean acidification data, the ocean acidification community is strongly encouraged to contribute to the data archiving effort, and help develop standard vocabularies describing the variables and define best practices for archiving ocean acidification data.

Early growth characteristics and the risk of reduced lung function and asthma : a meta-analysis of 25,000 children

Peer reviewed

Early growth characteristics and the risk of reduced lung function and asthma : a meta-analysis of 25,000 children

Peer reviewed