Opinions of the Supreme Court and Court of Appeals of South Carolina advance sheet no. 23

The Clerk of Court’s Office publishes the South Carolina Advance Sheets that contain the published opinions and orders of the Supreme Court and the Court of Appeals, along with notices, rule changes and other documents of general interest

Opinions of the Supreme Court and Court of Appeals of South Carolina advance sheet no. 24

The Clerk of Court’s Office publishes the South Carolina Advance Sheets that contain the published opinions and orders of the Supreme Court and the Court of Appeals, along with notices, rule changes and other documents of general interest

Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce

Efforts to ‘modernize’ the clinical workforce of the English National Health Service have sought to reconfigure the responsibilities of professional groups in pursuit of more effective, joined-up service provision. Such efforts have met resistance from professions eager to protect their jurisdictions, deploying legitimacy claims familiar from the insights of the sociology of professions. Yet to date few studies of professional boundaries have grounded these insights in the specific context of policy challenges to the inter- and intra-professional division of labour, in relation the medical profession and other health-related occupations. In this paper we address this gap by considering the experience of newly instituted general practitioners (family physicians) with a special interest (GPSIs) in genetics, introduced to improve genetics knowledge and practice in primary care. Using qualitative data from four comparative case studies, we discuss how an established intra-professional division of labour within medicine—between clinical geneticists and GPs—was opened, negotiated and reclosed in these sites. We discuss the contrasting attitudes towards the nature of genetics knowledge and its application of GPSIs and geneticists, and how these were used to advance conflicting visions of what the nascent GPSI role should involve. In particular, we show how the claims to knowledge of geneticists and GPSIs interacted with wider policy pressures to produce a rather more conservative redistribution of power and responsibility across the intra-professional boundary than the rhetoric of modernization might suggest.

Symptoms, functioning and quality of life after treatment in a residential sub-acute mental health service in Australia

Life-cycle portfolio choice with liquid and illiquid financial assets

Traditionally, quantitative models that have studied households׳ portfolio choices have focused exclusively on the different risk properties of alternative financial assets. We introduce differences in liquidity across assets in the standard life-cycle model of portfolio choice. More precisely, in our model, stocks are subject to transaction costs, as considered in recent macroliterature. We show that when these costs are calibrated to match the observed infrequency of households׳ trading, the model is able to generate patterns of portfolio stock allocation over age and wealth that are constant or moderately increasing, thus more in line with the existing empirical evidence.

Mixing theory for culture and harvest in bioreactors of human mesenchymal stem cells on microcarriers

The use of human mesenchymal stem cells (hMSCs) in regenerative medicine is a potential major advance for the treatment of many medical conditions, especially with the use of allogeneic therapies where the cells from a single donor can be used to treat ailments in many patients. Such cells must be grown attached to surfaces and for large scale production, it is shown that stirred bioreactors containing ~200 μm particles (microcarriers) can provide such a surface. It is also shown that the just suspended condition, agitator speed NJS, provides a satisfactory condition for cell growth by minimizing the specific energy dissipation rate, εT, in the bioreactor whilst still meeting the oxygen demand of the cells. For the cells to be used for therapeutic purposes, they must be detached from the microcarriers before being cryopreserved. A strategy based on a short period (~7 min) of very high εT, based on theories of secondary nucleation, is effective at removing >99% cells. Once removed, the cells are smaller than the Kolmogorov scale of turbulence and hence not damaged. This approach is shown to be successful for culture and detachment in 4 types of stirred bioreactors from 15 mL to 5 L.

Preferência do local de cuidados dos doentes em fim de vida: revisão sistemática da literatura

PROBLEMÁTICA: Com o aumento da população e comummente com o aumento de doenças crónicas, leva a um crescimento de doentes que necessitam de cuidados paliativos. A intervenção em cuidados paliativos visa o alívio do sofrimento e melhorar a qualidade de vida do doente e sua família, respeitando as suas preferências e desejos. Os profissionais de saúde necessitam de formação em Cuidados Paliativos, respeitando as expetativas dos doentes e permitir que a pessoa seja cuidada no seu local preferido de cuidados e não recorrer consecutivamente a urgências e internamentos de agudos. OBJETIVOS: Demonstrar a importância da identificação da preferência do local de cuidados dos doentes em fim-de-vida, compreender a importância do planeamento de cuidados e Diretivas antecipadas de vontade (DAV), relacionar a escolha do local de cuidados com o local de morte, identificar os fatores que influenciam e condicionam a escolha do local de cuidados dos doentes em fim-de-vida e por fim, perceber a organização e qualidade dos serviços. DESENHO: Revisão sistemática da literatura que inclui estudos de natureza qualitativa. METODOLOGIA: Foram incluídos oito estudos, publicados entre 1 de Janeiro de 2016 e 31 de Agosto 2016, pesquisados em bases de dados de referência e com acesso ao texto integral. RESULTADOS: Este estudo demonstra a importância das preferências dos doentes e serem registadas, a importância das Diretivas Antecipadas de Vontade, bem como o planeamento do cuidado de forma antecipada. É fundamental ter em conta os fatores que influenciam e condicionam a escolha do local de cuidados. CONCLUSÃO: Deve dar-se importância às preferências do local de cuidado dos doentes em fim-de-vida. Os doentes em fim-de-vida na sua globalidade preferem ser cuidados e morrerem em casa. As equipas multidisciplinares desenvolvem um papel preponderante no cuidado aos doentes em fim-de-vida. Quando os cuidados prestados são de alta qualidade, permite ao doente ser cuidado e morrer no seu local preferido.

Footrot caracterization in serra da estrela native flocks

Objectives: Serra da Estrela native (SEN) breed of sheep is one of the most important in Portugal, standing responsible for the production of one of the most internationally recognized cheeses in the world, "Queijo Serra da Estrela” (protected designation of origin). One of the major risks to the sustainability of SEN dairy flocks if footrot, an infectious diseases that causes lameness, decrease in milk production, weight loss and decrease in fertility.The aim of this work was to determine which parameters become decisive for the appearance of footrot in SEN dairy flocks, while establishing associations with environmental and nutritional variables. Materials and methods: The present study was carried out by performing an especially designed 27 multiple choice questionnaire, based on the underlying causes of lameness in livestock and in the clinical diagnosis performed by the vet techinichian of the clinical cases evaluated at the moment of the inquiry. The survey was performed during the execution of the oficial veterinary health program between February and September of 2014 by a veterinarian team from the Association of SEN Sheep Breeders (ANCOSE). The ovine producers (N=30, with a total of 1270 animals) were randomly selected from the extense area of production of “Queijo Serra da Estrela”. The parameters evaluated in the study were: season and consequent weather changes during the period of the study, floor types, hygiene conditions, bed types, the existence and use of footbaths, location of footbaths, foot trimming and foot hygiene procedures. After the construction of the database and using the Statistical Package for Social Sciences version 16.0 the frequency response for each item was calculated. Results: All SEN livestock producers are proactive in the treatment of lameness (70%). About 99.7% of lameness was related with footroot and most appeared in winter (36.7%). In some occasions there was not a specific season distribution (56.7% rainiest years). From the analyzed farms, 70% use straw as a floor bed, followed by bush (21%). 45.6% of animals were clinically diagnosed with footrot and were sheltered in straw floor. Bed quality is good in 40%, however frequent changes in the floor bed in the preceding 15 days had a higher rate of footroot diagnosed cases (33,23%) compared to monthly changes. Regarding sheepfold animal number, the distribution is proper in 36.7%, elevated in 30%, overcrowded in 6.7% and low in 23.3%. Clinically ill diagnosed animals in last category were the lowest observed (3%). Concerning hoof trimming, 76.7% trims while 23.3% reported not to perform that task. From those that perform trimming, 73.9% do it only when necessary, 21.7% at the time of clipping and 4.4% when the animal is affected. One curious result was that animals who perform trimming at clipping had higher footrot cases (52.6%), unlike those who trim only when necessary (40.2%) or even when animals are clinically ill (0.91%). Mostly all in the presence of footrot choose a local treatment (95.2%) using antibiotic sprays, instead of parenteral antibiotic treatment. Footbath is rarely used in the prevention (13.3%) of this disease and when it is misconceived (25%) and incorrectly formulated (100%). Conclusion: This study is the first performed in Portugal focusing on footrot caracterization in native SEN flocks. The economic impact in SEN dairy flocks is atributed to factors such as the direct decrease in milk and meat production, the early slaughter of affected animals due to a non responsive treatment, and medical expenses. The most effective eradication method combines first of all the ability to understand the problems of SEN producers and then the implementation of preventive measures and treatment of footrot. Often linked to the lack of formation, and the advanced age of portuguese producers, the mentality and social factors block the advance of veterinarian intervention itself.

Effect of investigation intensity and treatment differences on prostate cancer survivor's physical symptoms, psychological well-being and health-related quality of life: a two country cross-sectional study.

Aim: To investigate effects on men's health and well-being of higher prostate cancer (PCa) investigation and treatment levels in similar populations. Participants: PCa survivors in Ireland where the Republic of Ireland (RoI) has a 50% higher PCa incidence than Northern Ireland (NI). Method: A cross-sectional postal questionnaire was sent to PCa survivors 2–18 years post-treatment, seeking information about current physical effects of treatment, health-related quality of life (HRQoL; EORTC QLQ-C30; EQ-5D-5L) and psychological well-being (21 question version of the Depression, Anxiety and Stress Scale, DASS-21). Outcomes in RoI and NI survivors were compared, stratifying into ‘late disease’ (stage III/IV and any Gleason grade (GG) at diagnosis) and ‘early disease’ (stage I/II and GG 2–7). Responses were weighted by age, jurisdiction and time since diagnosis. Between-country differences were investigated using multivariate logistic and linear regression. Results: 3348 men responded (RoI n=2567; NI n=781; reflecting population sizes, response rate 54%). RoI responders were younger; less often had comorbidities (45% vs 38%); were more likely to present asymptomatically (66%; 41%) or with early disease (56%; 35%); and less often currently used androgen deprivation therapy (ADT; 2%; 28%). Current prevalence of incontinence (16%) and impotence (56% early disease, 67% late disease) did not differ between RoI and NI. In early disease, only current bowel problems (RoI 12%; NI 21%) differed significantly in multivariate analysis. In late disease, NI men reported significantly higher levels of gynaecomastia (23% vs 9%) and hot flashes(41% vs 19%), but when ADT users were analysed separately, differences disappeared. For HRQoL, in multivariate analysis, only pain (early disease: RoI 11.1, NI 19.4) and financial difficulties (late disease: RoI 10.4, NI 7.9) differed significantly between countries. There were no significant between-country differences in DASS-21 or index ED-5D-5L score. Conclusions: Treatment side effects were commonly reported and increased PCa detection in RoI has left more men with these side effects. We recommended that men be offered a PSA test only after informed discussion.

Síndrome da boca ardente

Resumo: O presente trabalho trata-se de uma revisão da literatura existente acerca da Síndrome da Boca Ardente e é colmatado com a apresentação de um caso clínico. Nele são apresentados e discutidos todos os parâmetros da doença com o objectivo final de apresentar e confrontar a informação já existente. O trabalho foi elaborado sempre visando a aplicação da informação na prática clínica do médico dentista generalista. Introdução: A Síndrome da Boca Ardente é uma doença identificada pela International Association for the Study of Pain como “uma entidade nosológica distinta” caracterizada por “sensação de dor ou ardor incessante acompanhada pela ausência de alterações objectivas na mucosa oral”. Objectivo: Apresentar as características da doença e organizar a informação com o intuito da sua aplicação prática. Materiais e métodos: Foi realizada uma pesquisa em duas bases de dados Pubmed e Scielo. Foram utilizados apenas artigos em inglês e preferivelmente com data de publicação a partir de 2000, embora não tenham sido usados limites temporais. O critério de inclusão foi o acesso ao texto integral. Conclusão: Foi possível concluir que é ainda necessário aprofundar a investigação no que diz respeito à fisiopatologia da doença, para que se avance para conclusões acerca da manutenção e tratamento de um paciente com Síndrome da Boca Ardente. Por outro lado, depois da organização das evidências relativas à história médica e exame clínico, a questão que se prende com o atraso de diagnóstico é uma que é merece atenção e para a qual a transmissão de informação parece ser a solução.

Opinions of the Supreme Court and Court of Appeals of South Carolina advance sheet no. 25

The Clerk of Court’s Office publishes the South Carolina Advance Sheets that contain the published opinions and orders of the Supreme Court and the Court of Appeals, along with notices, rule changes and other documents of general interest

Opinions of the Supreme Court and Court of Appeals of South Carolina advance sheet no. 26

The Clerk of Court’s Office publishes the South Carolina Advance Sheets that contain the published opinions and orders of the Supreme Court and the Court of Appeals, along with notices, rule changes and other documents of general interest

Opinions of the Supreme Court and Court of Appeals of South Carolina advance sheet no. 27

The Clerk of Court’s Office publishes the South Carolina Advance Sheets that contain the published opinions and orders of the Supreme Court and the Court of Appeals, along with notices, rule changes and other documents of general interest

Opinions of the Supreme Court and Court of Appeals of South Carolina advance sheet no. 28

The Clerk of Court’s Office publishes the South Carolina Advance Sheets that contain the published opinions and orders of the Supreme Court and the Court of Appeals, along with notices, rule changes and other documents of general interest

Opinions of the Supreme Court and Court of Appeals of South Carolina advance sheet no. 29

The Clerk of Court’s Office publishes the South Carolina Advance Sheets that contain the published opinions and orders of the Supreme Court and the Court of Appeals, along with notices, rule changes and other documents of general interest