Natural immunoglobulins (contribution to a debate on biomedical education)

Immunology has contributed to biomedical education in many important ways since the creation of scientific medicine in the last quarter of the 19th century. Today, immunology is a major area of biomedical research. Nevertheless, there are many basic problems unresolved in immunological activities and phenomena. Solving these problems is probably necessary to devise predictable and safe ways to produce new vaccines, treat allergy and autoimmune diseases and perform safe transplants. This challenge involves not only technical developments but also changes in attitude, of which the most fundamental is to abandon the traditional stimulus-response perspective in favor of more "systemic" views. Describing immunological activities as the operation of a complex multiconnected network, raises biological and epistemological issues not usually dealt with in biomedical education. Here we point to one example of systemic approaches. A new form of immunoblot (Panama blot), by which the reaction of natural immunoglobulins with complex protein mixtures may be analyzed by a special software and multivariate statistics, has been recently used to characterize human autoimmune diseases. Our preliminary data show that Panama blots can also be used to characterize global (systemic) immunogical changes in chronic human parasitic diseases, such as malaria and schistosomiasis mansoni, that correlate with the clinical status.

Hybrid Multiscale Finite Volume method for two-phase flow in porous media

We present a novel hybrid (or multiphysics) algorithm, which couples pore-scale and Darcy descriptions of two-phase flow in porous media. The flow at the pore-scale is described by the Navier?Stokes equations, and the Volume of Fluid (VOF) method is used to model the evolution of the fluid?fluid interface. An extension of the Multiscale Finite Volume (MsFV) method is employed to construct the Darcy-scale problem. First, a set of local interpolators for pressure and velocity is constructed by solving the Navier?Stokes equations; then, a coarse mass-conservation problem is constructed by averaging the pore-scale velocity over the cells of a coarse grid, which act as control volumes; finally, a conservative pore-scale velocity field is reconstructed and used to advect the fluid?fluid interface. The method relies on the localization assumptions used to compute the interpolators (which are quite straightforward extensions of the standard MsFV) and on the postulate that the coarse-scale fluxes are proportional to the coarse-pressure differences. By numerical simulations of two-phase problems, we demonstrate that these assumptions provide hybrid solutions that are in good agreement with reference pore-scale solutions and are able to model the transition from stable to unstable flow regimes. Our hybrid method can naturally take advantage of several adaptive strategies and allows considering pore-scale fluxes only in some regions, while Darcy fluxes are used in the rest of the domain. Moreover, since the method relies on the assumption that the relationship between coarse-scale fluxes and pressure differences is local, it can be used as a numerical tool to investigate the limits of validity of Darcy's law and to understand the link between pore-scale quantities and their corresponding Darcy-scale variables.

Phylogeny of the kinetoplastida: taxonomic problems and insights into the evolution of parasitism

To further investigate phylogeny of kinetoplastid protozoa, the sequences of small subunit (18S) ribosomal RNA of nine bodonid isolates and ten isolates of insect trypanosomatids have been determined. The root of the kinetoplastid tree was attached to the branch of Bodo designis and/or Cruzella marina. The suborder Trypanosomatina appeared as a monophyletic group, while the suborder Bodonina was paraphyletic. Among bodonid lineages, parasitic organisms were intermingled with free-living ones, implying multiple transitions to parasitism and supporting the `vertebrate-first hypothesis'. The tree indicated that the genera Cryptobia and Bodo are artificial taxa. Separation of fish cryptobias and Trypanoplasma borreli as different genera was not supported. In trypanosomatids, the genera Leptomonas and Blastocrithidia were polyphyletic, similar to the genera Herpetomonas and Crithidia and in contrast to the monophyletic genera Trypanosoma and Phytomonas. This analysis has shown that the morphological classification of kinetoplastids does not in general reflect their genetic affinities and needs a revision.

A Proportional Approach to Bankruptcy Problems with a guaranteed minimum

In a distribution problem, and specfii cally in bankruptcy issues, the Proportional (P) and the Egalitarian (EA) divisions are two of the most popular ways to resolve the conflict. The Constrained Equal Awards rule (CEA) is introduced in bankruptcy literature to ensure that no agent receives more than her claim, a problem that can arise when using the egalitarian division. We propose an alternative modi cation, by using a convex combination of P and EA. The recursive application of this new rule finishes at the CEA rule. Our solution concept ensures a minimum amount to each agent, and distributes the remaining estate in a proportional way. Keywords: Bankruptcy problems, Proportional rule, Equal Awards, Convex combination of rules, Lorenz dominance. JEL classi fication: C71, D63, D71.

Solidarity and uniform rules in bankruptcy problems

The idea of ensuring a guarantee (a minimum amount of the resources) to each agent has recently acquired great relevance, in both social and politi- cal terms. Furthermore, the notion of Solidarity has been treated frequently in redistribution problems to establish that any increment of the resources should be equally distributed taking into account some relevant characteris- tics. In this paper, we combine these two general concepts, guarantee and solidarity, to characterize the uniform rules in bankruptcy problems (Con- strained Equal Awards and Constrained Equal Losses rules). Keywords: Constrained Equal Awards, Constrained Equal Losses, Lower bounds, Bankruptcy problems, Solidarity. JEL classification: C71, D63, D71.

A New Approach for Bounding Awards in Bankruptcy Problems

The solution for the ‘Contested Garment Problem’, proposed in the Babylonic Talmud, suggests that each agent should receive at least some part of the resources whenever the demand overcomes the available amount. In this context, we propose a new method to define lower bounds on awards, an idea that has underlied the theoretical analysis of bankruptcy problems from its beginning (O’Neill, 1982) to present day (Dominguez and Thomson, 2006). Specifically, starting from the fact that a society establishes its own set of ‘Commonly Accepted Equity Principles’, our proposal ensures to each agent the smallest amount she gets according to all the admissible rules. As in general this new bound will not exhaust the estate, we analyze its recursive application for different sets of equity principles. Keywords: Bankruptcy problems, Bankruptcy rules, Lower bounds, Recursive process

Drug Problems - Can Substitute Prescribing Services Help You? Leaflet

Drug Problems - Can Substitute Prescribing Services Help You? Leaflet

Report of the Working Group on Treatment of Under 18 olds Presenting to Treatment Services with Serious Drug Problems

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Report of Working Group set up by the Tanaiste in March 2006 to examine the nature and extent of Haemochromatosis in Ireland and to advise her on the action necessary to address the problems caused by Haemochromatosis

It was agreed at a meeting on 15th February, 2006, between Ms Mary Harney, TD, Tanaiste and Minister for Health and Children and Dr Maurice Manning that a Working Group would be set up to examine all of the issues relating to haemochromatosis in Ireland and to advise her on the actions necessary to address these issues. Read the Report (PDF, 709kb)  

An algebraic operator approach to the analysis of Gerber-Shiu functions

We introduce an algebraic operator framework to study discounted penalty functions in renewal risk models. For inter-arrival and claim size distributions with rational Laplace transform, the usual integral equation is transformed into a boundary value problem, which is solved by symbolic techniques. The factorization of the differential operator can be lifted to the level of boundary value problems, amounting to iteratively solving first-order problems. This leads to an explicit expression for the Gerber-Shiu function in terms of the penalty function.

Attachment and temperament in early childhood; implications for later behavior problems.

In the context of a French validation study, the Child Behavior Checklist (CBCL) was administered to more than 3000 French speaking mothers of 5-year-old children. Scores were factor-analyzed. Principal components analysis revealed four dimensions: externalizing and internalizing behavior problems, immaturity and somatoform disorders. Another sample of 40 mothers participated in a longitudinal study, filling in the CBCL when their children were 5 years old. These children had been observed previously in the Strange Situation (SSP) at 21 months. Several dichotomous variables derived from the SSP (e.g. secure versus insecure, proximal versus distal interaction with the mother, avoidant behavior) have been used as predictors of the four dimensions extracted from the CBCL. Hierarchical regressions showed that proximal behaviors with the mother, which reflect temperamental characteristics independently of the quality of attachment, predicted internalizing problems, whereas avoidance of the mother, or insecure-avoidant attachment, predicted internalizing as well as externalizing problems at 5 years of age. These results show that attachment and temperament, as assessed by the SSP, may each have specific implications for later behavior problems.

Don't cover up your problems

This pocket-sized leaflet advises young men not to cover up their problems and on the steps they can take to promote good mental health, such as keeping active, talking through problems and taking time to relax.

Risky single occasion drinking frequency and alcohol-related consequences: can abstinence during early adulthood lead to alcohol problems?

QUESTIONS UNDER STUDY: the main purpose of this longitudinal study was to determine the impact of risky single occasion drinking (RSOD) frequency on alcohol dependence and drinking consequences reported 15 months later. METHODS: As a baseline sample, 5,990 young men were assessed on their drinking habits including the frequency of RSOD. Of them, 5,196 were reassessed at follow-up 15 months later on RSOD frequency, alcohol dependence and alcohol related consequences in thze interceding year. Drop out biases were investigated. RESULTS: Around 45% of the baseline participants reported regular RSOD (every month or more frequently). Despite the fact that RSOD distribution was generally stable during the initial sample, 47.4% reported a variation of their RSOD frequency 15 months later. Around 25% of the sample reported reduced RSOD frequency. Nonetheless, occasional RS drinkers were more likely to become regular (monthly) RSO drinkers at follow up. Daily and weekly RSOD were associated with high proportions of alcohol dependence and detrimental consequences of drinking. Surprisingly, abstainers at baseline were more likely to be at risk of alcohol dependence and consequences at follow up than non-RSO drinkers. CONCLUSIONS: Despite the fact that alcohol abstinence is logically the best way to avoid the detrimental consequences of alcohol drinking, abstainers at baseline reported as many problems due to alcohol use at follow up as occasional or monthly RSO drinkers. The few participants who had become RSO drinkers during the follow up period were indeed likely to engage in detrimental behaviour. Non-RSO drinkers had the fewest problems due to alcohol use. This substantiates the early occurrence of drinking consequences among inexperienced RSO drinkers.

Fuel Poverty and Cold Home-related Health Problems

Evidence Review 7 - Tackling fuel poverty and cold home-related health problems Briefing 7 - Fuel poverty and cold home-related health problems This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, address the health impacts of fuel poverty and cold homes. These documents provide an overview of fuel poverty, describing the evidence linking fuel poverty, cold homes, and poor health outcomes. They examine the scale of the problem across England and trends over time. Evidence shows that living in cold homes is associated with poor health outcomes and an increased risk of morbidity and mortality for all age groups. The documents also provide a brief overview of national policy and sets out the role of local authorities and potential interventions at local level. Fuel poverty is not just about poverty, but also about the quality of England’s housing stock and energy efficiency. The review discusses some of the interventions that have been implemented at the local level to help people on low incomes during cold weather and to address cold home-related health problems. The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

A Study of Alcohol Problems and Marriage from a Treatment Perspective

This thesis is concerned with alcohol problems and marital relationships. It is particularly interested in these dynamics from a treatment perspective. The study addresses theory, research and clinical practice in the field of alcohol problems. It specifically considers these areas as they relate to enhancing understanding of the dynamics between alcohol problems and marriage. The study examines three theoretical paradigms, the disease concept of addiction, behavioural/cognitive behavioural and systems based approaches to understanding alcohol addiction. This provides a multiple theory base from which research in the field and the clinical data collected in the current research is analysed and interpreted. The study reviews research findings that have contributed to the recognition of marital treatment interventions as significant in the alcohol field. It highlights the discrepancies between such research findings and developments in actual clinical practice. In doing so, the study illustrates the gap between theory, research and clinical practice. The need for a more effective framework of information exchange across these areas of activity is identified and a model for better exchange is presented and discussed. This model highlights the importance of including clients' experiences to influence policy, practice, theory and research. In the research, specific attention is focused on the experiences of couples in alcohol treatment. Clinical data is collected from a series of alcohol treatment couples group therapy sessions. The research analysis of the clinical data identifies and extracts concerns as expressed by couples in treatment. Interpretation of these identified concerns or themes is conducted by employing the theoretical constructs of the three selected theoretical paradigms in conjunction with group work theory. On the basis of the findings in this thesis a model for a maritally sensitive assessment framework is developed. The model identifies a number of factors that should be considered in order to enhance appreciation of the interaction between alcohol problems and marital dynamics. This has particular significance for treatment interventions.This resource was contributed by The National Documentation Centre on Drug Use.