Health-related quality of life in the Cambridge City over-75s Cohort (CC75C): development of a dementia-specific scale and descriptive analyses.

BACKGROUND: The assessment of Health Related Quality of Life (HRQL) is important in people with dementia as it could influence their care and support plan. Many studies on dementia do not specifically set out to measure dementia-specific HRQL but do include related items. The aim of this study is to explore the distribution of HRQL by functional and socio-demographic variables in a population-based setting. METHODS: Domains of DEMQOL's conceptual framework were mapped in the Cambridge City over 75's Cohort (CC75C) Study. HRQL was estimated in 110 participants aged 80+ years with a confirmed diagnosis of dementia with mild/moderate severity. Acceptability (missing values and normality of the total score), internal consistency (Cronbach's alpha), convergent, discriminant and known group differences validity (Spearman correlations, Wilcoxon Mann-Whitney and Kruskal-Wallis tests) were assessed. The distribution of HRQL by socio-demographic and functional descriptors was explored. RESULTS: The HRQL score ranged from 0 to 16 and showed an internal consistency Alpha of 0.74. Validity of the instrument was found to be acceptable. Men had higher HRQL than women. Marital status had a greater effect on HRQL for men than it did for women. The HRQL of those with good self-reported health was higher than those with fair/poor self-reported health. HRQL was not associated with dementia severity. CONCLUSIONS: To our knowledge this is the first study to examine the distribution of dementia-specific HRQL in a population sample of the very old. We have mapped an existing conceptual framework of dementia specific HRQL onto an existing study and demonstrated the feasibility of this approach. Findings in this study suggest that whereas there is big emphasis in dementia severity, characteristics such as gender should be taken into account when assessing and implementing programmes to improve HRQL.

The factorial structure of the 41-item version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Spanish population of 8 to 12 years-old

On this instrumental study we intend to analyse the factorial structure of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Spanish sample using exploratory and confirmatory factorial analysis. As a second objective we intend to develop a short form of it for rapid screening and, finally, to analyze the reliabilities of both questionnaires. The SCARED was administered to a community sample of 1,508 children aged between 8 and 12 years. The sample was randomly split using half for the exploratory analysis and the other half for the confirmatory study. Furthermore a reduced version of the SCARED was developed using the SchmidLeiman procedure. Exploratory Factor Analysis yielded a four factor structure comprised of Somatic/panic, Generalized anxiety, Separation anxiety and Social phobia factors This structure was confirmed using Confirmatory Factor Analysis. The four factors, the full scale and the short scale showed good reliabilities. The results obtained seem to indicate that the Spanish version of the SCARED has good internal consistency, and along with other recent results, has a structure of four related factors that replicates the dimensions proposed for anxiety disorders by the DSM-IV-TR

H3PW12O40 (HPA), an efficient and reusable catalyst for biodiesel production related reactions: esterification of oleic acid and etherification of glycerol

In esterification of oleic acid with methanol at 25 °C HPA displayed the highest activity. Moreover the HPA could be reused after being transformed into its cesium salt. In the reaction of etherification of glycerol HPA and Amberlyst 35W showed similar initial activity levels. The results of acid properties demonstrate that HPA is a strong protonic acid and that both surface and bulk protons contribute to the acidity. Because of its strong affinity for polar compounds, HPA is also seemingly dissolved in both oleic acid and methanol. The reaction in this case proceeds with the catalyst in the homogenous phase.

Managing regulatory risks when outsourcing network-related services in the electricity distribution sector

Deregulation of the electricity sector liberated the electricity sale and production for competitive forces while in the network business, electricity transmission and distribution, natural monopoly positions were recognised. Deregulation was accompanied by efficiencyoriented thinking on the whole electricity supply industry. For electricity distribution this meant a transition from a public service towards profit-driven business guided by economic regulation. Regulation is the primary means to enforce societal and other goals in the regulated monopoly sector. The design of economic regulation is concerned with two main attributes; end-customer price and quality of electricity distribution services. Regulation limits the costs of the regulated company but also defines the desired quality of monopoly services. The characteristics of the regulatory framework and the incentives it provides are therefore decisive for the electricity distribution sector. Regulation is not a static factor; changes in the regulatory practices cause discontinuity points, which in turn generate risks. A variety of social and environmental concerns together with technological advancements have emphasised the relevance of quality regulation, which is expected to lead to the large-scale replacement of overhead lines with underground cables. The electricity network construction activity is therefore currently witnessing revolutionary changes in its competitive landscape. In a business characterised by high statutory involvement and a high level of sunk costs, recognising and understanding the regulatory risks becomes a key success factor. As a response, electricity distribution companies have turned into outsourcing to attain efficiency and quality goals. This doctoral thesis addresses the impacts of regulatory risks on electricity network construction, which is a commonly outsourced activity in the electricity distribution network sector. The chosen research approach is characterised as an action analytical research on account of the fact that regulatory risks are greatly dependent on the individual nature of the regulatory regime applied in the electricity distribution sector. The main contribution of this doctoral thesis is to develop a concept for recognising and managing the business risks stemming from economic regulation. The degree of outsourcing in the sector is expected to increase in years to come. The results of the research provide new knowledge to manage the regulatory risks when outsourcing services.

Word Equations and Related Topics. Independence, Decidability and Characterizations

The three main topics of this work are independent systems and chains of word equations, parametric solutions of word equations on three unknowns, and unique decipherability in the monoid of regular languages. The most important result about independent systems is a new method giving an upper bound for their sizes in the case of three unknowns. The bound depends on the length of the shortest equation. This result has generalizations for decreasing chains and for more than three unknowns. The method also leads to shorter proofs and generalizations of some old results. Hmelevksii’s theorem states that every word equation on three unknowns has a parametric solution. We give a significantly simplified proof for this theorem. As a new result we estimate the lengths of parametric solutions and get a bound for the length of the minimal nontrivial solution and for the complexity of deciding whether such a solution exists. The unique decipherability problem asks whether given elements of some monoid form a code, that is, whether they satisfy a nontrivial equation. We give characterizations for when a collection of unary regular languages is a code. We also prove that it is undecidable whether a collection of binary regular languages is a code.

Is professional recognition in plastic surgery related to activity in research

OBJECTIVE: To evaluate the relation of medical research, with the participation of prominent plastic surgeon in Congress.METHODS: We reviewed the scientific programs of the last 3 Brazilian Congress of Surgery, were selected 21 Brazilian plástic surgeons invited to serve as panelists or speakers in roundtable sessions in the last 3 congresses (Group 1). We randomly selected and paired by other members (associates) of the Brazilian Society of Plastic Surgery, with no participation in congress as speaker (Group 2). We conducted a search for articles published in journals indexed in Medline, Lilacs and SciELO for all doctors selected during the entire academic career and the last 5 years from March 2007 until March 2012. We assessed the research activity through the simple counting of the number of publications in indexed journals for each professional. The number of publications groups was compared.RESULTS: articles produced throughout career: Group 1- 639 articles (average of 30.42 items each). Group 2- 79 articles (mean 3.95 articles each). Difference between medias: p <0.001.CONCLUSION: The results demonstrate that the Brazilian Society of Plastic Surgery seeking professionals with a greater number of publications and journals of higher impact. This approach encourages new members to pursue a higher qualification, and give security to congressmen, they can rely on the existence of a technical criterion in the choice of speakers.

CFH Y402H polymorphism and response to intravitreal Ranibizumab in brazilian patients with neovascular age-related macular degeneration

Objective: To investigate the association between CFH gene polymorphism and response to ranibizumab in Brazilian patients with neovascular age-related macular degeneration (AMD).Methods: 95 patients were genotyped for the CFH rs1061170 (Y402H) single nucleotide polymorphism. Patients with neovascular AMD initially received intravitreal ranibizumab injections for three months and were retreated as needed. Visual acuity (VA) and central retinal thickness (CRT) were measured before treatment and at 1, 3, 6, and 12 months post-treatment.Results: For patients with the TT and TC genotypes, paired comparisons of VA showed a statistically significant improvement when the data obtained at all visits were compared with baseline. Patients homozygous for the risk genotype (CC) did not show a statistically significant improvement when VA obtained at visits 1, 3, 6 and 12 were compared with baseline. For all genotypes, paired comparisons of CRT showed a statistically significant improvement when the data obtained at visits 1, 3, 6 and 12 were compared with baseline.Conclusion: Patients with the CC genotype showed poorer long-term functional response to intravitreal ranibizumab.

Neural mechanisms underlying conscious and unconscious vision. Evidence from event-related potentials and transcranial magnetic stimulation

Vision affords us with the ability to consciously see, and use this information in our behavior. While research has produced a detailed account of the function of the visual system, the neural processes that underlie conscious vision are still debated. One of the aims of the present thesis was to examine the time-course of the neuroelectrical processes that correlate with conscious vision. The second aim was to study the neural basis of unconscious vision, that is, situations where a stimulus that is not consciously perceived nevertheless influences behavior. According to current prevalent models of conscious vision, the activation of visual cortical areas is not, as such, sufficient for consciousness to emerge, although it might be sufficient for unconscious vision. Conscious vision is assumed to require reciprocal communication between cortical areas, but views differ substantially on the extent of this recurrent communication. Visual consciousness has been proposed to emerge from recurrent neural interactions within the visual system, while other models claim that more widespread cortical activation is needed for consciousness. Studies I-III compared models of conscious vision by studying event-related potentials (ERP). ERPs represent the brain’s average electrical response to stimulation. The results support the model that associates conscious vision with activity localized in the ventral visual cortex. The timing of this activity corresponds to an intermediate stage in visual processing. Earlier stages of visual processing may influence what becomes conscious, although these processes do not directly enable visual consciousness. Late processing stages, when more widespread cortical areas are activated, reflect the access to and manipulation of contents of consciousness. Studies IV and V concentrated on unconscious vision. By using transcranial magnetic stimulation (TMS) we show that when early visual cortical processing is disturbed so that subjects fail to consciously perceive visual stimuli, they may nevertheless guess (above chance-level) the location where the visual stimuli were presented. However, the results also suggest that in a similar situation, early visual cortex is necessary for both conscious and unconscious perception of chromatic information (i.e. color). Chromatic information that remains unconscious may influence behavioral responses when activity in visual cortex is not disturbed by TMS. Our results support the view that early stimulus-driven (feedforward) activation may be sufficient for unconscious processing. In conclusion, the results of this thesis support the view that conscious vision is enabled by a series of processing stages. The processes that most closely correlate with conscious vision take place in the ventral visual cortex ~200 ms after stimulus presentation, although preceding time-periods and contributions from other cortical areas such as the parietal cortex are also indispensable. Unconscious vision relies on intact early visual activation, although the location of visual stimulus may be unconsciously resolved even when activity in the early visual cortex is interfered with.

Beauty for Sale - An Empirical Study of Appearance-Related Consumption in Finland

This study examines appearance-related consumption in Finland. The theoretical portion discusses appearance-related consumption, on one hand from a consumer culture perspective, as both a possibility and responsibility for everyone; and on the other hand, from the point of view of behaviour and attitudes associated with sociodemographic and lifestyle-related factors. The empirical part of the study concentrates on the following aspects: 1) Finns’ appearance-related consumption patterns, attitudes towards appearance-related consumption and attending to one’s looks through consumption, as well as general changes in consumption patterns and attitudes; 2) gender differences in attitudes and consumption patterns, and their possible changes over time, and; 3) other differences among population groups in attitudes and consumption patterns, and their possible changes over time. The following dissertation utilises data from seven different nationally representative surveys. Data include Finnish Household Budget surveys from 1998 (N=4 359), 2001 (N=5 495) and 2006 (N=4 007), as well as, The Everyday Life and Well-being Survey (N=908) collected in 2011, and Finland 1999 (N=2 417), Finland 2004 (N=3 574) and Finland 2009 (N=1 202) surveys. The study indicates that Finns’ relationship to appearance-related consumption is, generally, somewhat inconsistent. In Finland, a significant share of a household’s total spending, around the EU average, is allocated to products and services related to appearance. In addition, at an attitudinal level, physical appearance is important to most Finnish consumers. However, in many respects, these attitudes reflect a certain reservation towards appearance-related consumption practices. The number of those consumers who see themselves as truly dedicated to attending to their looks through consumption is quite small, whereas the amount of those willing to take a reserved or even negative attitude towards appearance-related consumption is clearly higher. Attitudes towards attending to one’s looks and the importance of appearance-related consumption had not changed during the past decade. Study shows that at present, appearance-related consumption is a form of consumption that is particularly important to women, younger consumers, people with middle or higher income, and those with normal weight. Gender is in the key role when explaining appearance-related consumption and contrary to common belief, gender differences seem to have stayed quite stable. The results also indicate that, to some extent, differences between younger and older age groups might be diminishing.

Increased expression of Interleukin-6 related to nephritis in chickens challenged with an Avian infectious bronchitis virus variant

A Brazilian field isolate (IBV/Brazil/PR05) of avian infectious bronchitis virus (IBV), associated with development of nephritis in chickens, was previously genotyped as IBV variant after S1 gene sequencing. The aim of this study was to evaluate the levels of IL-6 in kidneys and trachea of birds vaccinated and challenged with IBV/Brazil/PR05 strain, correlating these results with scores of microscopic lesions, specific IBV antigen detection and viral load. The up-regulation of IL-6 and the increased levels of viral load on renal and tracheal samples were significantly correlated with scores of microscopic lesions. Reduced levels of viral load were detected in kidneys of birds previously vaccinated and challenged, compared to non-vaccinated challenged group, although markedly microscopic lesions were observed for both groups. The expression of IL-6, present both in the kidney and in the tracheas, was dependent on the load of the virus present in the tissue, and the development of lesions was related with IL-6 present in the tissues. These data suggest that variant IBV/Brazil/PR05 can induce the expression of proinflammatory cytokines in a manner correlated with viral load and increased IL-6 is involved in the tissue with the influx of inflammatory cells and subsequent nephritis. This may contribute with a model to the development of immunosuppressive agents of IL-6 to prevent acute inflammatory processes against infection with IBV and perhaps other coronaviruses, as well as contribute to the understanding of the immunopathogenesis of IBV nephropatogenic strains.

Structure-related magnetic fabric studies : implications for deformed and undeformed Precambrian rocks

The aim of this thesis research was to gain a better understanding of the emplacement of rapakivi granite intrusions, as well as the emplacement of gold-bearing hydrothermal fluids in structurally controlled mineralizations. Based on investigations of the magnetic fabric, the internal structures could be analysed and the intrusion mechanisms for rapakivi granite intrusions and respectively different deformation stages within gold-bearing shear and fault zones identified. Aeromagnetic images revealed circular structures within the rapakivi granite batholiths of Wiborg, Vehmaa and Åland. These circular structures represent intrusions that eventually build up these large batholiths. The rapakivi granite intrusions of Vehmaa, Ruotsinpyhtää within the Wiborg batholith and Saltvik intrusions within the Åland batholith all show bimodal magnetic susceptibilities with paramagnetic and ferromagnetic components. The distribution of the bimodality is related to different magma batches of the studied intrusions. The anisotropy of magnetic susceptibility (AMS) reveals internal structures that cannot be studied macroscopically or by microscope. The Ruotsinpyhtää and Vehmaa intrusions represent similar intrusion geometries, with gently to moderately outward dipping magnetic foliations. In the case of Vehmaa, the magnetic lineations are gently plunging and trend in the directions of the slightly elongated intrusion. The magnetic lineations represent magma flow. The shapes of the AMS ellipsoids are also more planar (oblate) in the central part of the intrusion, whereas they become more linear (prolate) near the margin. These AMS results, together with field observations, indicate that the main intrusion mechanism has involved the subsidence of older blocks with successive intrusion of fractionated magma during repeated cauldron subsidence. The Saltvik area within the Åland batholith consists of a number of smaller elliptical intrusions of different rapakivi types forming a multiple intrusive complex. The magnetic fabric shows a general westward dipping of the pyterlite and eastward dipping of the contiguous even-grained rapakivi granite, which indicates a central inflow of magma batches towards the east and west resulting from a laccolitic emplacement of magma batches, while the main mechanism for space creation was derived from subsidence. The magnetic fabric of structurally controlled gold potential shear and fault zones in Jokisivu, Satulinmäki and Koijärvi was investigated in order to describe the internal structures and define the deformation history and emplacement of hydrothermal fluids. A further aim of the research was to combine AMS studies with palaeomagnetic methods to constrain the timing for the shearing event relative to the precipitation of ferromagnetic minerals and gold. All of the studied formations are dominated by monoclinic pyrrhotite. The AMS directions generally follow the tectonic structures within the formations. However, internal variations in the AMS direction as well as the shapes of the AMS ellipsoids are observed within the shear zones. In Jokisivu and Satulinmäki in particular, the magnetic signatures of the shear zone core differ from the margins. Furthermore, the shape of the magnetic fabric in the shear zone core of Jokisivu is dominated by oblate shapes, whereas the margins exhibit prolate shapes. These variations indicate a later effect of the hydrothermal fluids on the general shear event. The palaeo-magnetic results reveal a deflection from the original Svecofennian age geomagnetic direction. These results, coupled with correlations between the orientation of the NRM vectors and the magnetic and rock fabrics, imply that the gold-rich hydrothermal fluids were emplaced pre/syntectonically during the late stages of the Svecofennian orogeny.

Creating an open-books implementation framework for a maintenance-related value-based life-cycle model

This study is a qualitative action research by its nature with elements of personal design in the form of a tangible model implementation framework construction. Utilized empirical data has been gathered via two questionnaires in relation to the arranged four workshop events with twelve individual participants. Five of them represented maintenance customers, three maintenance service providers and four equipment providers respectively. Further, there are two main research objectives in proportion to the two complementary focusing areas of this thesis. Firstly, the value-based life-cycle model, which first version has already been developed prior to this thesis, requires updating in order to increase its real-life applicability as an inter-firm decision-making tool in industrial maintenance. This first research objective is fulfilled by improving appearance, intelligibility and usability of the above-mentioned model. In addition, certain new features are also added. The workshop participants from the collaborating companies were reasonably pleased with made changes, although further attention will be required in future on the model’s intelligibility in particular as main results, charts and values were all reckoned as slightly hard to understand. Moreover, upgraded model’s appearance and added new features satisfied them the most. Secondly and more importantly, the premises of the model’s possible inter-firm implementation process need to be considered. This second research objective is delivered in two consecutive steps. At first, a bipartite open-books supported implementation framework is created and its different characteristics discussed in theory. Afterwards, the prerequisites and the pitfalls of increasing inter-organizational information transparency are studied in empirical context. One of the main findings was that the organizations are not yet prepared for network-wide information disclosure as dyadic collaboration was favored instead. However, they would be willing to share information bilaterally at least. Another major result was that the present state of companies’ cost accounting systems will definitely need implementation-wise enhancing in future since accurate and sufficiently detailed maintenance data is not available. Further, it will also be crucial to create supporting and mutually agreed network infrastructure. There are hardly any collaborative models, methods or tools currently in usage. Lastly, the essential questions about mutual trust and predominant purchasing strategies are cooperation-wise important. If inter-organizational activities are expanded, a more relational approach should be favored in this regard. Mutual trust was also recognized as a significant cooperation factor, but it is hard to measure in reality.

Phytoplankton flora of two rivers in Southeast Brazil: Paraibuna and Pomba Rivers, Minas Gerais

This work is a survey of the phytoplankton communities of the Paraibuna and Pomba Rivers. It aims is to contribute to the existing albeit scarce knowledge of the phytoplankton of Minas Gerais and of lotic phytoplankton in general. The results are based on 32 samples collected from Paraibuna and Pomba Rivers, in Minas Gerais State, during the dry (July and August, 2001) and rainy seasons (February 2002). Forty-eight taxa were identified, 20 from Paraibuna River and 28 from Pomba River, thirty-eight of which are new records for Minas Gerais State. The phytoplankton community of Paraibuna River was strongly influenced by a reservoir close to its source, thus the occurrence of lentic species of cyanobacteria and desmids. However, the phytoplankton community of Pomba River was typical of lotic environments, with great number of diatoms and desmids.

Effect of all-trans retinoic acid on newly diagnosed acute promyelocytic leukemia patients: results of a Brazilian center

Thirty-seven patients with acute promyelocytic leukemia (APL) were treated with all-trans retinoic acid (ATRA). Patients received 45 mg m-2 day-1 po of ATRA until complete remission (CR) was achieved, defined as: a) presence of less than 5% blasts in the bone marrow, with b) white blood cells >103/mm3, c) platelets >105/mm3 and d) hemoglobin concentration >8 g/dl, with no blood or platelet transfusions. Thirty-one (83.7%) patients achieved CR by day 50, and 75% of these before day 30. Correction of the coagulopathy, achieved between days 2 and 10 (mean, 3 days), was the first evidence of response to treatment. Only one patient had been previously treated with chemotherapy and three had the microgranular variant M3 form. Dryness of skin and mucosae was the most common side effect observed in 82% of the patients. Thrombosis, hepatotoxicity and retinoid acid syndrome (RAS) were observed in 7 (19%), 6 (16%) and 4 (11%) patients, respectively. Thirteen (35%) patients had to be submitted to chemotherapy due to hyperleukocytosis (above 40 x 103/mm3) and six of these presented with new signs of coagulopathy after chemotherapy. Four (11%) patients died secondarily to intracerebral hemorrhage (IH) and two (5.4%) dropped out of the protocol due to severe ATRA side effects (one RAS and one hepatotoxicity). RAS and IH were related strictly to hyperleukocytosis. The reduced use of platelets and fresh frozen plasma probably lowered the total cost of treatment. We conclude that ATRA is an effective agent for inducing complete remission in APL patients.

Abnormal proliferative response of the carotid artery of spontaneously hypertensive rats after angioplasty may be related to the depolarized state of its smooth muscle cells

Hypertension is one of the major precursors of atherosclerotic vascular disease, and vascular smooth muscle abnormal cell replication is a key feature of plaque formation. The present study was conducted to examine the relationship between hypertension and smooth muscle cell proliferation after balloon injury and to correlate neointima formation with resting membrane potential of uninjured smooth muscle cells, since it has been suggested that altered vascular function in hypertension may be related to the resetting of the resting membrane potential in spontaneously hypertensive rats (SHR). Neointima formation was induced by balloon injury to the carotid arteries of SHR and renovascular hypertensive rats (1K-1C), as well as in their normotensive controls, i.e., Wistar Kyoto (WKY) and normal Wistar (NWR) rats. After 14 days the animals were killed and the carotid arteries were submitted to histomorphometric and immunohistochemical analyses. Resting membrane potential measurements showed that uninjured carotid arteries from SHR smooth muscle cells were significantly depolarized (-46.5 ± 1.9 mV) compared to NWR (-69 ± 1.4 mV), NWR 1K-1C (-60.8 ± 1.6 mV), WKY (-67.1 ± 3.2 mV) and WKY 1K-1C (-56.9 ± 1.2 mV). The SHR arteries responded to balloon injury with an enhanced neointima formation (neo/media = 3.97 ± 0.86) when compared to arteries of all the other groups (NWR 0.93 ± 0.65, NWR 1K-1C 1.24 ± 0.45, WKY 1.22 ± 0.32, WKY 1K-1C 1.15 ± 0.74). Our results indicate that the increased fibroproliferative response observed in SHR is not related to the hypertensive state but could be associated with the resetting of the carotid smooth muscle cell resting membrane potential to a more depolarized state.