Multiprofessional Views on Older Patients' Participation in Care Planning Meetings in a Hospital Context

Care planning meetings (CPMs; sometimes referred to as family meetings) for older patients involve group decision-making between the multidisciplinary team, the older person and their family. However, service user participation is challenged by the inequity of knowledge and power between participants, together with organisational and resource pressures for timely discharge. The effective use and perhaps, potential misuse of communication strategies within CPMs is of ethical concern to all participants. Habermas' essential critique of participatory communication provides insight as to how older people's involvement can be either enabled or blocked by healthcare professionals (HCPs) depending on their use of communication strategies. Seven discipline-specific mini-focus groups provided an opportunity for HCPs to reflect on the participation of patients over 65 and their families in CPMs. Findings explore HCPs' understanding of older patients involvement based on key dimensions of communicative participation, namely, mutuality, inclusiveness, patient centredness and clear outcomes. Whilst the benefits of collaborative decision-making were confirmed, legitimate concerns as to the quality of participatory practices, limited attention to group work processes and the exclusion of older patients with cognitive impairment were identified. © 2013 Copyright British Association of Social Workers.

Gifts, Loans and Intergenerational Support for Young Adults

Young adults in the UK are increasingly dependent on family support to offset the costs of living independently. This article explores these complex intergenerational exchanges from the perspective of a group of single young adults in their mid-twenties to mid-thirties who had been in receipt of various forms of financial and material support from family members since leaving the parental home. We outline the nature of this support and then consider how these forms of assistance are understood by those in receipt of them. We conclude that the co-existence of a sense of both gratitude and discomfort which is often generated by these exchanges is managed but by no means resolved by a blurring of the boundaries between gifts and loans, a set of negotiations which may not even be an option amongst less advantaged young adults.

Common variants at the MHC locus and at chromosome 16q24.1 predispose to Barrett's esophagus

Barrett's esophagus is an increasingly common disease that is strongly associated with reflux of stomach acid and usually a hiatus hernia, and it strongly predisposes to esophageal adenocarcinoma (EAC), a tumor with a very poor prognosis. We report the first genome-wide association study on Barrett's esophagus, comprising 1,852 UK cases and 5,172 UK controls in the discovery stage and 5,986 cases and 12,825 controls in the replication stage. Variants at two loci were associated with disease risk: chromosome 6p21, rs9257809 (P(combined) = 4.09 × 10(-9); odds ratio (OR) = 1.21, 95% confidence interval (CI) =1.13-1.28), within the major histocompatibility complex locus, and chromosome 16q24, rs9936833 (P(combined) = 2.74 × 10(-10); OR = 1.14, 95% CI = 1.10-1.19), for which the closest protein-coding gene is FOXF1, which is implicated in esophageal development and structure. We found evidence that many common variants of small effect contribute to genetic susceptibility to Barrett's esophagus and that SNP alleles predisposing to obesity also increase risk for Barrett's esophagus.

Government Aid and Film Legislation : 'An elastoplast to stop a haemorrhage'

This chapter explores the relationship between the British film industry and the government throughout the 1970s and evaluates the levels of support offered to the industry in an uncertain political deade.

British Film Censorship and the BBFC in the 1970s

This chapter is an exploration of film censorship in the 1970s and the role of the British Board of Film Censors. It draws on material from the BBFC archive files and addresses issues of popular taste, taboo and changing standards of permission.

Dual-Reflector Antenna with a Reflectarray Subreflector for Wide Beam Scanning Range at 120GHz

A dual-reflector antenna composed by a small reconfigurable reflectarray subreflector and a large parabolic main reflector is proposed for beam scanning application in the 120 GHz frequency band. The beam scanning is achieved by changing the phase distribution on the reflectarray surface which is supposed to contain reconfigurable cells. The phase distribution for the different beam deflecting states is obtained with a synthesis technique based on the analysis of the antenna in receive mode.

Gamma Irradiation and Targeted Radionuclides Enhance the Expression of the Noradrenaline Transporter Transgene Controlled by the Radio-Inducible p21(WAF1/CIP1) Promoter

The use of radiation-inducible promoters to drive transgene expression offers the possibility of temporal and spatial regulation of gene activation. This study assessed the potential of one such promoter element, p21(WAF1/CIP1) (WAF1), to drive expression of the noradrenaline transporter (NAT) gene, which conveys sensitivity to radioiodinated meta-iodobenzylguanidine (MIBG). An expression vector containing NAT under the control of the radiation-inducible WAF1 promoter (pWAF/NAT) was produced. The non-NAT expressing cell lines UVW (glioma) and HCT116 (colorectal cancer) were transfected with this construct to assess radiation-controlled WAF1 activation of the NAT gene. Transfection of UVW and HCT cells with pWAF/NAT conferred upon them the ability to accumulate [(131)I]MIBG, which led to increased sensitivity to the radiopharmaceutical. Pretreatment of transfected cells with ? radiation or the radiopharmaceuticals [(123)I]MIBG or [(131)I]MIBG induced dose- and time-dependent increases in subsequent [(131)I]MIBG uptake and led to enhanced efficacy of [(131)I]MIBG-mediated cell kill. Gene therapy using WAF1-driven expression of NAT has the potential to expand the use of this therapeutic modality to tumors that lack a radio-targetable feature.

Comparison of frequency-selective screen-based linear to circular split-ring polarisation convertors

This study presents the use of periodic arrays of freestanding slot frequency-selective screens (FSS) as a means for generating circularly polarised signals from an incident linearly polarised signal at normal incidence to the structure. Measured and simulated results for crossed, linear and various ring slot element shapes in single and double-layer polarisation convertor structures are presented for 10 GHz operation. It is shown that 3 dB axial ratio (AR) bandwidths of 21% can be achieved with the one-layer perforated screen design and that the rate of change is lower than the double-layer structures. An insertion loss of 0.34 dB can be achieved for the split circular ring double-layer periodic array, and of the three topologies presented the hexagonal split-ring polarisation convertor gives the lowest variation of AR with angle of incidence 1.8 dB/45° and 3.6 dB/45° for the single and double-screen FSS, respectively. In addition, their tolerance to angle of incidence variation is presented. The capability of the surfaces reported here as twist polariser or spatial isolator components has been demonstrated with up to -30 dB isolation between incident and re-reflected signals for the double-layer designs being measured. © 2010 The Institution of Engineering and Technology.

Design and experimental validation of liquid crystal-based reconfigurable reflectarray elements with improved bandwith in F-band

A reconfigurable reflectarray which exploits the dielectric anisotropy of liquid crystals (LC) has been designed to operate in the frequency range from 96 to 104 GHz. The unit cells are composed of three unequal length parallel dipoles placed above an LC substrate. The reflectarray has been designed using an accurate model which includes the effects of anisotropy and inhomogeneity. An effective permittivity that accounts for the real effects of the LC has also been used to simplify the analysis and design of the unit cells. The geometrical parameters of the cells have been adjusted to simultaneously improve the bandwidth, maximize the tunable phase-range and reduce the sensitivity to the angle of incidence. The performance of the LC based unit cells has been experimentally evaluated by measuring the reflection amplitude and phase of a reflectarray consisting of 52x54 identical cells. The good agreement between measurements and simulations validate the analysis and design techniques and demonstrate the capabilities of the proposed reflectarray to provide beam scanning in F band.

Design of engineered reflectors for radar cross section modification

A technique is proposed for the design of engineered reflectors consisting of doubly periodic arrays printed on thin grounded dielectric substrates that reflect an incoming wave from a given incoming direction to a predetermined outgoing direction. The proposed technique is based on a combination of Floquet theory for propagation in periodic structures and reflect-array principles. A flat surface designed to reflect a TE polarized wave incident at 45 back in the direction of the impinging signal at 14.7 GHz is employed as an example. By means of full-wave simulations, it is demonstrated that the monostatic RCS of a finite reflector is comparable with the specular RCS of a metallic mirror of the same dimensions. It is further shown that comparably high monostatic RCS values are obtained for angles of incidence in the 30-60 range, which are frequency dependent and thus open opportunities for target localization. A prototype array is fabricated and experimentally tested for validation. The proposed solution can be used to modify the radar cross section of a target. Other potential applications are also discussed. © 1963-2012 IEEE.

A time-resolved immunoassay to measure serum antibodies to the rotavirus VP6 capsid protein

The rotavirus (RV) inner capsid protein VP6 is widely used to evaluate immune response during natural infection and in vaccine studies. Recombinant VP6 from the most prevalent circulating rotavirus strains in each subgroup (SG) identified in a birth cohort of children in southern India [SGII (G1P[8]) and SGI (G10P[11])] were produced. The purified proteins were used to measure VP6-specific antibodies in a Dissociation-Enhanced Lanthanide Fluorometric Immunoassay (DELFIA). The ability of the assay to detect a =2 fold rise in IgG level in a panel of serum samples from a longitudinal study was compared to a gold standard virus-capture ELISA. A strong association was observed between the assays (p

Rotavirus enterotoxin NSP4 has mucosal adjuvant properties

Rotavirus nonstructural protein 4 (NSP4) is a protein with pleiotropic properties. It functions in rotavirus morphogenesis, pathogenesis, and is the first described viral enterotoxin. Since many bacterial toxins function as potent mucosal adjuvants, we evaluated whether baculovirus-expressed recombinant simian rotavirus SA11 NSP4 possesses adjuvant activity by co-administering NSP4 with keyhole limpet hemocyanin (KLH), tetanus toxoid (TT) or ovalbumin (OVA) as model antigens in mice. Following intranasal immunization, NSP4 significantly enhanced both systemic and mucosal immune responses to model immunogens, as compared to the control group, in an antigen-specific manner. Both full-length and a cleavage product of SA11 NSP4 had adjuvant activity, localizing this activity to the C-terminus of the protein. NSP4 forms from virulent and avirulent porcine rotavirus OSU strain, and SA11 NSP4 localized within a 2/6-virus-like particle (VLP) also exhibited adjuvant effects. These studies suggest that the rotavirus enterotoxin NSP4 can function as an adjuvant to enhance immune responses for a co-administered antigen.

Polarisation independent split ring frequency selective surface

A frequency selective surface (FSS) is described which exhibits coincident spectral responses for TE and TM polarisation when the FSS operates at 45 degrees incidence. The structure consists of two closely spaced arrays of ring elements with the conductor split at one or two locations to provide independent control of the resonances for the vertical and horizontal field directions. The FSS is designed to diplex two channels separated by an edge of a band ratio of 1.7:1 and yield a common - 10 dB reflection bandwidth of 10.2%. Measured and numerical results are shown to be in good agreement over the frequency range 9-12 GHz.