Placental contribution to the origins of sexual dimorphism in health and diseases: sex chromosomes and epigenetics

Sex differences occur in most non-communicable diseases, including metabolic diseases, hypertension, cardiovascular disease, psychiatric and neurological disorders and cancer. In many cases, the susceptibility to these diseases begins early in development. The observed differences between the sexes may result from genetic and hormonal differences and from differences in responses to and interactions with environmental factors, including infection, diet, drugs and stress. The placenta plays a key role in fetal growth and development and, as such, affects the fetal programming underlying subsequent adult health and accounts, in part for the developmental origin of health and disease (DOHaD). There is accumulating evidence to demonstrate the sex-specific relationships between diverse environmental influences on placental functions and the risk of disease later in life. As one of the few tissues easily collectable in humans, this organ may therefore be seen as an ideal system for studying how male and female placenta sense nutritional and other stresses, such as endocrine disruptors. Sex-specific regulatory pathways controlling sexually dimorphic characteristics in the various organs and the consequences of lifelong differences in sex hormone expression largely account for such responses. However, sex-specific changes in epigenetic marks are generated early after fertilization, thus before adrenal and gonad differentiation in the absence of sex hormones and in response to environmental conditions. Given the abundance of X-linked genes involved in placentogenesis, and the early unequal gene expression by the sex chromosomes between males and females, the role of X- and Y-chromosome-linked genes, and especially those involved in the peculiar placenta-specific epigenetics processes, giving rise to the unusual placenta epigenetic landscapes deserve particular attention. However, even with recent developments in this field, we still know little about the mechanisms underlying the early sex-specific epigenetic marks resulting in sex-biased gene expression of pathways and networks. As a critical messenger between the maternal environment and the fetus, the placenta may play a key role not only in buffering environmental effects transmitted by the mother but also in expressing and modulating effects due to preconceptional exposure of both the mother and the father to stressful conditions.

Requirements, Issues, and Challenges for Sense and Avoid in Unmanned Aircraft Systems

The sense and avoid capability is one of the greatest challenges that has to be addressed to safely integrate unmanned aircraft systems into civil and nonsegregated airspace. This paper gives a review of existing regulations, recommended practices, and standards in sense and avoid for unmanned aircraft systems. Gaps and issues are identified, as are the different factors that are likely to affect actual sense and avoid requirements. It is found that the operational environment (flight altitude, meteorological conditions, and class of airspace) plays an important role when determining the type of flying hazards that the unmanned aircraft system might encounter. In addition, the automation level and the data-link architecture of the unmanned aircraft system are key factors that will definitely determine the sense and avoid system requirements. Tactical unmanned aircraft, performing similar missions to general aviation, are found to be the most challenging systems from an sense and avoid point of view, and further research and development efforts are still needed before their seamless integration into nonsegregated airspace

What's in it for us? A case study research about micro sense making processes through the eyes of front line employees, during culture change implementation

Abstract How employees make sense of change is a very complex process. Recently, academics have neglected to research sense making activities in a micro culture implementation context, through the eyes of front line employees. In contrast to a macro view, a micro perspective limits researchers to only look at an individual, departmental or group level. By doing so, we can zoom in on the details of sense making processes that employees use in their daily work life. A macro (organisational) view is based on the notion that there is a general integrated culture that can be found in all organisational units and departments. It is assumed that culture can be researched by using the entire organisation as one single research entity. This thesis challenges this assumption. In case of planned change it is usually the management community who are in charge of the change intervention. Because of their formal hierarchical position, they have the power to abort or initiate change programs. It is perhaps therefore that researchers tend to be focused on the management community rather than on lower level organisational members, such as front line employees. Apart from the micro view, scholars also neglected to research culture change implementation through the eyes of front line employees. This thesis is an attempt to fill these two gaps that currently exists in academic change management publications. The main research question is therefore: From a micro point of view how do front-line employees make sense of the impact of culture change, during the implementation phase? This thesis starts with a literature review which exposes the two main gaps. The most important outcome of this review is that only 2% of the research articles dealt with culture implementation, through the eyes of front line employees. A conceptual research model is built on the integrated sense making theory of Weber and Manning (2001) and the micro variables of Raelin and Cataldo (2011). These theories emphasize elements of sense making in a daily working context. It is likely that front line employees can identify themselves with research elements such as tasks, skills practices, involvement and behaviour. Front line employees were selected, because as lower level organisational members they are usually the change recipients. They are further away from the change initiating scene (usually the management of an organisation) and form a potential sense making ‘hotspot’ that could provide new academic insights. In order to carry out the primary research, two case organisations were selected in the leisure industry. A participative case study research method was chosen. This meant that the researcher worked in the concerning departments of the case organisations. The goal was to observe and interview front line employees, while they were performing their jobs. The most important advantage of this approach is that the researcher temporarily becomes one with the organisation and is therefore able to acquire both formal and informal narratives that front line employees use during sense making activities. It was found that front line employees make sense of organisational change by using a practical approach. They make sense of the change program by carrying out new tasks, developing new skills and sharing best practices. The most noticeable conclusion was that sense making activities predominantly take place at an individual level in relation to change acceptance. Organisational members tend to create a mental equation in order to weigh the advantages against the disadvantages. They evaluate whether the concerning change program is beneficial to them or not. For future research a sense making scheme model is suggested that is based on two methods: an introspection and an action method.

Sense making by middlemanagement

Aanleiding voor het onderzoek Deze scriptie sluit aan bij de afstudeerkring “effectieve verandermanagers”. Aanleiding voor dit onderzoek was de brede vraag “Wat onderscheidt een effectieve veranderingsmanager op het middenniveau in organisaties van een minder effectieve bij het implementeren van veranderingen?” Binnen deze brede vraag past de centrale vraagstelling in dit onderzoek: “Welke neerwaartse activiteiten oefenen middenmanagers uit in een sensemakingproces tijdens een verandering?“ Middenmanager Allereerst definiëren we het begrip ‘middenmanager’. De middenmanager bevindt zich op een kruispunt: In de verticale lijn tussen het topmanagement en de werkvloer, op de horizontale lijn tussen de diverse afdelingen (Nonaka,1994). Ten behoeve van mijn onderzoek sluit ik mij aan bij de positionering van Huy (2001). Hij plaatst de middenmanager 2 lagen onder de CEO en 1 laag boven lijnmedewerkers en professionals. In een veranderingsproces heeft de middenmanager verschillende rollen te vervullen. Deze verschillende rollen zijn, onder anderen, beschreven door Huy (2001) en Quinn (1998). Zij noemen: entrepreneur, communicator en therapeut, stimulator, mentor, innovator, bemiddelaar, producent, bestuurder, coördinator, controleur. De onderzoekers zijn het er over eens dat de middenmanager moet balanceren en doseren in de verschillende rollen om effectief te kunnen zijn in een veranderingsproces. Sensemakingproces Dit onderzoek probeert meer kennis te genereren over welke neerwaartse activiteiten middenmanagers uitoefenen gedurende een sensemakingproces tijdens een verandering. We definiëren het begrip ‘sensemakingproces’. Het sensemakingproces vindt plaats als mensen geconfronteerd worden met boodschappen of gebeurtenissen die nieuw zijn. Door met deze nieuwe informatie te kijken naar de bestaande werkelijkheid, is een bewustwording op gang geholpen die kan leiden tot verandering. Er is nog weinig onderzoek gedaan naar de activiteiten (wat doen middenmanagers op dagelijkse basis) van middenmanagers in sensemakingprocessen. Rouleau & Balogun (2007) hebben dat wel onderzocht en onderscheiden de volgende vier sensegivingactiviteiten: het uitrollen van netwerken; het distribueren van gedachten door het voeren van gesprekken; het identificeren van sociale en culturele systemen. Relevantie onderzoek De externe validiteit van het hierboven genoemde onderzoek van Rouleau & Balogun (2007) is echter beperkt, doordat deze is uitgevoerd onder een kleine populatie in Canada en het Verenigd Koninkrijk. Mijn onderzoek wil een bijdrage leveren aan de toename van de externe validiteit door te verifiëren of de neerwaartse activiteiten van de middenmanager die gevonden zijn in het onderzoek van Rouleau & Balogun (2007) middels een andere onderzoeksmethode en met een andere onderzoekspopulatie (de Nederlandse zorginstelling Tactus). Wat betreft de praktische relevantie kan gezegd worden dat mijn onderzoek meer inzicht geeft aan de middenmanagers in welke activiteiten zij uitvoeren of zouden kunnen uitvoeren. Zij kunnen zich bewust worden van hun mogelijkheden om invloed uit te oefenen op het sensemakingproces van hun medewerkers. Ik verwacht daarmee hun effectiviteit te vergroten. Centrale vraag en deelvragen Bij de centrale vraag kunnen de volgende deelvragen geformuleerd worden: 1. Wat is de rol van middenmanagers in een sensemakingproces tijdens een verandering? 2. Zijn de neerwaartse sensemakingactiviteiten van middenmanagers (uit de studie van Rouleau & Balogun, 2007) ook te identificeren zijn binnen één Nederlandse GGZ-stichting? 3. Zijn er andere neerwaartse sensemakingactiviteiten van middenmanagers te identificeren? Conceptuele model Het model dat de basis is voor de beantwoording van de tweede en derde deelvraag, is gebaseerd op de literatuur. In dit model worden de sensemakingactiviteiten van de middenmanager als een onafhankelijke variabele gezien die direct invloed heeft op het sensemakingproces binnen het team. Daarbij kunnen we enkele mediërende en modererende factoren onderscheiden. Als modererende factor noemen we, ten eerste, de mate waarin voor het teamlid het persoonlijke triggerpoint bereikt is. Hoe dichter genaderd, hoe meer kans op verandering bij dit teamlid (Kloosterboer, 2008). Ten tweede noemen we het sneeuwbaleffect van de positieve feedback (Kelman, 2005): hoe verder in het proces, hoe meer kans op verandering. Tenslotte noemen we als modererende factor het emotiemanagement van de middenmanager. Hoe meer de middenmanager in staat is de balans te vinden, hoe meer kans op verandering (Huy, 2002). Als mediërende factor kunnen we de horizontale sensegiving noemen, ofwel de sensegiving door peers (Balogun & Johnson, 2005). Deze sensegiving kan, los van de sensemakingactiviteiten van de manager een geheel eigen verandering op gang brengen. Het kan dus gezien worden als (een deel van) de verklaring voor het sensemakingproces binnen het team. Dit onderzoek beperkt zich tot het bestuderen van de sensemakingactiviteiten van de middenmanager en hun effect op het sensemakingproces binnen het team. In het onderzoek worden de modererende factoren en de mediërende factor dus niet meegenomen. Onderzoeksopzet Het onderzoek is opgesteld als multiple-case design, toetsend onderzoek. Toetsend, omdat de externe validering van de neerwaartse sensemakingactiviteiten van de middenmanager nog laag is. Het multiple-case design biedt de mogelijkheid om cases met elkaar te vergelijken en bredere steun te vinden voor de geformuleerde proposities. De voorgenomen bronnen waren een (één op één) interview met acht middenmanagers, een groepsinterview met meerdere medewerkers per middenmanager en documenten. De focus in alle interviews was de middenmanager en diens sensemakingactiviteiten. De opgevraagde en aangeleverde documenten zijn echter geen adequate bron van informatie gebleken. Resultaten De eerste deelvraag is beantwoord middels literatuurstudie. De onderzoekers zijn het er over eens dat de middenmanager moet balanceren en doseren in de verschillende rollen om effectief te kunnen zijn in een veranderingsproces. De tweede en derde deelvraag werden beantwoord middels een multiple-case design onderzoek. De resultaten uit dit onderzoek laten zien dat de neerwaartse sensemakingactiviteiten uit de studie van Rouleau & Balogun (2007), inderdaad gevonden werden binnen de genoemde GGZ-stichting. De hypothese is daarmee geverifieerd. De derde conclusie is dat er geen andere neerwaartse sensemakingactiviteiten van middenmanagers zijn geïdentificeerd. Door de verkregen informatie over de vier sensemakingactiviteiten van middenmanager terug te brengen naar handelingsniveau, is zichtbaar geworden dat er verschillen zijn tussen de middenmanagers. De handelingen in gezamenlijkheid leidden wel tot de vier sensemakingactiviteiten. Discussie De casestudie heeft geen nieuwe activiteiten aangetoond. Dat maakt de definiëring van het begrip steviger. Door de vier sensemakingactiviteiten (Rouleau & Balogun, 2007) op een derde niveau op te delen in kleinere eenheden, draagt deze casestudie tevens bij aan een nadere definiëring van het begrip ‘neerwaartse sensemakingactiviteiten van de middenmanager’. Door de verduidelijking van het begrip is kwantitatief onderzoek beter mogelijk, waardoor nu ook causale verbanden tussen de neerwaartse sensemakingactiviteiten van de middenmanager en de sensemaking bij de medewerkers gemaakt kunnen worden. Aanbevelingen In een vervolgonderzoek zou het conceptuele model deels of geheel onderzocht kunnen worden. Met een dergelijk onderzoek, of meerdere onderzoeken zou meer duidelijkheid kunnen komen over de mate van invloed van de mediërende factoren en modererende factor op de sensemaking. Aanbeveling voor verder onderzoek is om de onderzoeksmethode te variëren of uit te breiden met bijvoorbeeld participerende observatie. Dan zou waarneming kunnen plaatsvinden vanuit het perspectief van een betrokkene (Yin, 2003). Een andere methode om de activiteiten beter te inventariseren is het laten bijhouden door managers van hun sensemakingactiviteiten. Een bijkomende propositie die dit onderzoek oplevert, is dat de relatie tussen al dan niet hebben van onbewuste kennis en het beschikken over ervaring als leidinggevende niet gelegd kan worden. Deze propositie zou verder onderzocht kunnen worden.

Hierarchical Task Network Planning with Common-Sense Reasoning for Multiple-People Behaviour Analysis

Safety on public transport is a major concern for the relevant authorities. We
address this issue by proposing an automated surveillance platform which combines data from video, infrared and pressure sensors. Data homogenisation and integration is achieved by a distributed architecture based on communication middleware that resolves interconnection issues, thereby enabling data modelling. A common-sense knowledge base models and encodes knowledge about public-transport platforms and the actions and activities of passengers. Trajectory data from passengers is modelled as a time-series of human activities. Common-sense knowledge and rules are then applied to detect inconsistencies or errors in the data interpretation. Lastly, the rationality that characterises human behaviour is also captured here through a bottom-up Hierarchical Task Network planner that, along with common-sense, corrects misinterpretations to explain passenger behaviour. The system is validated using a simulated bus saloon scenario as a case-study. Eighteen video sequences were recorded with up to six passengers. Four metrics were used to evaluate performance. The system, with an accuracy greater than 90% for each of the four metrics, was found to outperform a rule-base system and a system containing planning alone.

Heart Transplantation in Patients Older than 65 Years: Worthwhile or Wastage of Organs?

BACKGROUND: Patients older than 65 years have traditionally not been considered candidates for heart transplantation. However, recent studies have shown similar survival. We evaluated immediate and medium-term results in patients older than 65 years compared with younger patients. METHODS: From November 2003 to December 2013, 258 patients underwent transplantation. Children and patients with other organ transplantations were excluded from this study. Recipients were divided into two groups: 45 patients (18%) aged 65 years and older (Group A) and 203 patients (81%) younger than 65 years (Group B). RESULTS: Patients differed in age (67.0 ± 2.2 vs. 51.5 ± 9.7 years), but gender (male 77.8 vs. 77.3%; p = 0.949) was similar. Patients in Group A had more cardiovascular risk factors and ischemic cardiomyopathy (60 vs. 33.5%; p < 0.001). Donors to Group A were older (38.5 ± 11.3 vs. 34.0 ± 11.0 years; p = 0.014). Hospital mortality was 0 vs. 5.9% (p = 0.095) and 1- and 5-year survival were 88.8 ± 4.7 versus 86.8 ± 2.4% and 81.5 ± 5.9 versus 77.2 ± 3.2%, respectively. Mean follow-up was 3.8 ± 2.7 versus 4.5 ± 3.1 years. Incidence of cellular/humoral rejection was similar, but incidence of cardiac allograft vasculopathy was higher (15.6 vs. 7.4%; p = 0.081). Incidence of diabetes de novo was similar (p = 0.632), but older patients had more serious infections in the 1st year (p = 0.018). CONCLUSION: Heart transplantation in selected older patients can be performed with survival similar to younger patients, hence should not be restricted arbitrarily. Incidence of infections, graft vascular disease, and malignancies can be reduced with a more personalized approach to immunosuppression. Allocation of donors to these patients does not appear to reduce the possibility of transplanting younger patients.

Towards Empowerment: Narrative Study of Counselling Psychology Trainees and How They Make Sense of Their Personal and Professional Development in the Context of Their Past Experiences

The discipline of counselling psychology continues to grow and change in response to social, economic and political pressures. It has been argued that its quest for a coherent and distinct identity, which emphasises the possibility of the coexistence of multiple approaches, creates an inherently uncertain and dilemmatic training environment that may hinder the development of trainees’ professional identities. In order to gain a deeper understanding of the issue at hand, the aim was to explore how final year trainees and newly qualified counselling psychologists constructed and made sense of their emerging professional identities and what experiences, past and present, they drew upon in the context of their training to shape those identities. Applying narrative inquiry to analyse eight open-ended interviews, eight preliminary themes were originally identified in participants’ narratives, which with further refinements lead to stories of struggle and marginalisation, growth and discovery, and power and resilience. Participants’ stories of struggle and marginalisation emerged in reference to early family dynamics and stressful life experiences, which seemed to also foster a strong identification with the counselling psychology profession, while stories of growth and discovery focused on the importance of having supportive figures, who helped to instill a sense of security and create an atmosphere of openness. It was in this learning environment that participants felt it was possible to develop a more resilient, empowered professional self, which allowed them to shed an earlier sense of struggle and vulnerability. However, where more of an emphasis was placed on power and resilience, there seemed to be less room for participants to express other feelings that came into conflict with their preferred sense of professional self. While there seems to be a need for a ‘safer’ climate, in which trainees could voice and acknowledge anxieties, vulnerabilities and limitations, addressing concerns around power and vulnerability that may be contributing to the silencing of particular voices and identities may be equally important if trainees are to develop coherent and distinct counselling psychologist identities.

Strategies to improve outcome following the transplantation of organs from brain-dead donors

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Alcohol consumption and the sense of coherence in young people in educational training

The rate of consumption of alcoholic beverages has undergone changes as well as the factors that influence it. In order to understand the significance of drinking patterns, this study was conducted with a sample of young adults (N = 260) ages 20 to 30, in Lisbon. The instruments used were The Alcohol Use Disorders Identification Test and the Sense of Coherence Questionnaire. The results show that 10.8% had problems with alcohol. Those who had a lower sense of coherence, especially in the dimension of investment capacity, presented with more harmful and risky consumption patterns. We conclude that health promotion behaviors should include measures to strengthen a sense of coherence

Fracionamento de kits de HMDP para marcação com 99mTc: influência da temperatura e da idade das frações

Mestrado em Medicina Nuclear - Área de especialização: Radiofarmácia

A Sense of Wonder: Enhancing Access to Folktales through Task and Facet Analysis

Discusses the approach taken in Phase 1 of a three-phase project Folktales, Facets and FRBR [funded by a grant from OCLC/ALISE]. This project works with the special collection of folktales at the Center for Children’s Books (CCB) at the University of Illinois at Urbana-Champaign, and the scholars who use this collection. The project aims to enhance the effectiveness and efficiency of folktale access through deep understanding of user needs. Phase 1 included facet analysis of the bibliographic records for a sample of 100 folktale books in the CCB, and task analysis of interviews with four CCB-affiliated faculty. Describes the information tasks, information seeking obstacles, and desired features for a discovery and access tool related to folktales for this initial group of scholarly users of folktales.

Sense-making in theory and practice: a metatheoretical foundation and application for health information seeking

This thesis attempts to provide deeper historical and theoretical grounding for sense-making, thereby illustrating its applicability to practical information seeking research. In Chapter One I trace the philosophical origins of Brenda Dervin’s theory known as “sense making,” reaching beyond current scholarship that locates the origins of sense-making in twentieth-century Phenomenology and Communication theory and find its rich ontological, epistemological, and etymological heritage that dates back to the Pre-Socratics. After exploring sense-making’s Greek roots, I examine sense-making’s philosophical undercurrents found in Hegel’s Phenomenology of Spirit (1807), where he also returns to the simplicity of the Greeks for his concept of sense. With Chapter Two I explore sense-making methodology and find, in light of the Greek and Hegelian dialectic, a dialogical bridge connecting sense-making’s theory with pragmatic uses. This bridge between Dervin’s situation and use occupies a distinct position in sense-making theory. Moreover, building upon Brenda Dervin’s model of sense-making, I use her metaphors of gap and bridge analogy to discuss the dialectic and dialogic components of sense making. The purpose of Chapter Three is pragmatic – to gain insight into the online information-seeking needs, experiences, and motivation of first-degree relatives (FDRs) of breast cancer survivors through the lens of sense-making. This research analyses four questions: 1) information-seeking behavior among FDRs of cancer survivors compared to survivors and to undiagnosed, non-related online cancer information seekers in the general population, 2) types of and places where information is sought, 3) barriers or gaps and satisfaction rates FDRs face in their cancer information quest, and 4) types and degrees of cancer information and resources FDRs want and use in their information search for themselves and other family members. An online survey instrument designed to investigate these questions was developed and pilot tested. Via an email communication, the Susan Love Breast Cancer Research Foundation distributed 322,000 invitations to its membership to complete the survey, and from March 24th to April 5th 10,692 women agreed to take the survey with 8,804 volunteers actually completing survey responses. Of the 8,804 surveys, 95% of FDRs have searched for cancer information online, and 84% of FDRs use the Internet as a sense-making tool for additional information they have received from doctors or nurses. FDRs report needing much more information than either survivors or family/friends in ten out of fifteen categories related to breast and ovarian cancer. When searching for cancer information online, FDRs also rank highest in several of sense-making’s emotional levels: uncertainty, confusion, frustration, doubt, and disappointment than do either survivors or friends and family. The sense-making process has existed in theory and praxis since the early Greeks. In applying sense–making’s theory to a contemporary problem, the survey reveals unaddressed situations and gaps of FDRs’ information search process. FDRs are a highly motivated group of online information seekers whose needs are largely unaddressed as a result of gaps in available online information targeted to address their specific needs. Since FDRs represent a quarter of the population, further research addressing their specific online information needs and experiences is necessary.

Heart Transplantation in Patients Older than 65 Years: Worthwhile or Wastage of Organs?

BACKGROUND: Patients older than 65 years have traditionally not been considered candidates for heart transplantation. However, recent studies have shown similar survival. We evaluated immediate and medium-term results in patients older than 65 years compared with younger patients. METHODS: From November 2003 to December 2013, 258 patients underwent transplantation. Children and patients with other organ transplantations were excluded from this study. Recipients were divided into two groups: 45 patients (18%) aged 65 years and older (Group A) and 203 patients (81%) younger than 65 years (Group B). RESULTS: Patients differed in age (67.0 ± 2.2 vs. 51.5 ± 9.7 years), but gender (male 77.8 vs. 77.3%; p = 0.949) was similar. Patients in Group A had more cardiovascular risk factors and ischemic cardiomyopathy (60 vs. 33.5%; p < 0.001). Donors to Group A were older (38.5 ± 11.3 vs. 34.0 ± 11.0 years; p = 0.014). Hospital mortality was 0 vs. 5.9% (p = 0.095) and 1- and 5-year survival were 88.8 ± 4.7 versus 86.8 ± 2.4% and 81.5 ± 5.9 versus 77.2 ± 3.2%, respectively. Mean follow-up was 3.8 ± 2.7 versus 4.5 ± 3.1 years. Incidence of cellular/humoral rejection was similar, but incidence of cardiac allograft vasculopathy was higher (15.6 vs. 7.4%; p = 0.081). Incidence of diabetes de novo was similar (p = 0.632), but older patients had more serious infections in the 1st year (p = 0.018). CONCLUSION: Heart transplantation in selected older patients can be performed with survival similar to younger patients, hence should not be restricted arbitrarily. Incidence of infections, graft vascular disease, and malignancies can be reduced with a more personalized approach to immunosuppression. Allocation of donors to these patients does not appear to reduce the possibility of transplanting younger patients.