The last taboo: A guide to dementia, sexuality, intimacy and sexual behaviour in care homes ILC-UK

The International Longevity Centre - UK��launched a new paper (Wednesday, 6th July 2011). The last taboo: A guide to dementia, sexuality, intimacy and sexual behaviour in care homes, provides care home workers and managers with information and practical advice on this complex, controversial and sensitive issue.The need for affection, intimacy and relationships for people with dementia in care homes has too often been ignored and side-lined in policy and practice. The onset of old age or a cognitive impairment does not erase the need for affection, intimacy and/or relationships. While the issues involved can be complex, controversial and sensitive and may challenge our own beliefs and value system, it is essential that we understand more about them to foster a more person-centred approach to dementia care. Care home residents with dementia often have complex care needs and trying to understand and respond to the more intimate and sexual aspects of a resident’s personality can be challenging.Aimed at care home workers and managers, the guide not only provides essential information on this aspect of dementia care but offers practical advice to support current work-based practices. Set out in an accessible and easy-to-read format, this guide includes case studies, questions, suggestions and a self assessment quiz to promote easy learning. It also provides a possible pathway for care home managers to develop a guiding policy on sexual expression in dementia.The guide for care staff is summarised in 10 key points:1. Some residents with dementia will have sexual or sensual needs.2. Affection and intimacy contribute to overall health and wellbeing for residents.3. Some residents with dementia will have the capacity to make decisions about their needs.4. If an individual in care is not competent to decide, the home has a duty of care towards the individual to ensure they are protected from harm.5. There are no hard and fast rules. Assess each situation on an individual basis6. Remember not everyone with dementia is heterosexual.7. Inappropriate sexual behaviour is not particularly common in dementia.8. Confront your own attitudes and behaviour towards older people and sex generally.9. Communicate – look at how you can improve communication with your colleagues, managers, residents and carers on this subject10. Look after yourself and remember your own needs as a care professional��The full paper is available: The Last Taboo

Women and Dementia - Not forgotten ILC-UK

ILC-UK recently (31 Aug 2011)��published a report calling for a gendered approach and response to dementia at the national and international level. The report posits that women will disproportionately bear the burden of dementia in terms of numbers, but also impact in the coming years. The ‘feminization of ageing’ is a widely recognised trend and yet hitherto a comprehensive approach to the impact of dementia on women remains largely under explored.Invariably women and men as they age, share many of the same fundamental needs. Yet, as is acknowledged in many parts of the world, older women are particularly vulnerable and are subject to prolonged inequalities experienced since childhood, for example, lower levels of education and a greater risk of poverty. This report assumes a life course approach to the challenge of dementia and women, arguing from a global perspective that women face a ‘triple jeopardy’ as a result of the associated stigma attached to their age, gender and decline in cognitive functions. ILC-UK make a number of recommendations for improving outcomes and interventions for women, which include: 1. Dementia health policies and programmes should incorporate a gender dimension in their design, delivery and evaluation2. Gender should be included as a key health determinant in the promotion and disease prevention of dementia3. Dementia research at the regional, national and international level needs to be disaggregated by gender and age4. Women and men should be equally represented and involved at the micro and macro level of decision-making with regard to the development of health and social care policies and resource allocation as they pertain to dementia5. There is a need for greater interdisciplinary research incorporating the biological and social models of health for men and women to improve health interventions and outcomesDownload the full pdf report here��

Omics meets hypothesis-driven research. Partnership for innovative discoveries in vascular biology and angiogenesis.

The emergence of omics technologies allowing the global analysis of a given biological or molecular system, rather than the study of its individual components, has revolutionized biomedical research, including cardiovascular medicine research in the past decade. These developments raised the prospect that classical, hypothesis-driven, single gene-based approaches may soon become obsolete. The experience accumulated so far, however, indicates that omic technologies only represent tools similar to those classically used by scientists in the past and nowadays, to make hypothesis and build models, with the main difference that they generate large amounts of unbiased information. Thus, omics and classical hypothesis-driven research are rather complementary approaches with the potential to effectively synergize to boost research in many fields, including cardiovascular medicine. In this article we discuss some general aspects of omics approaches, and review contributions in three areas of vascular biology, thrombosis and haemostasis, atherosclerosis and angiogenesis, in which omics approaches have already been applied (vasculomics).

Steps to deal with stress - A simple guide to stressing less and enjoying life more

The Steps to deal with stress booklet provides tips and practical advice on coping with stress in your life and covers recognizing stress, getting ready, coping better, learning from bad experiences and taking action now. Simple steps such as relaxation exercises and talking to someone can help you feel better and put you in a better frame of mind for dealing with your problems.

Construction and Quantitative Evaluation of a Dual Specific Promoter System for Monitoring the Expression Status of Stra8 and c-kit Genes.

Applications of genetic constructs with multiple promoters, which are fused with reporter genes and simultaneous monitoring of various events in cells, have gained special attention in recent years. Lentiviral vectors, with their distinctive characteristics, have been considered to monitor the developmental changes of cells in vitro. In this study, we constructed a novel lentiviral vector (FUM-M), containing two germ cell-specific promoters (Stra8 and c-kit), fused with ZsGreen and DsRed2 reporter genes, and evaluated its efficiency in different cells following treatments with retinoic acid and DMSO. Several cell lines (P19, GC-1 spg and HEK293T) were transduced with this vector, and functional capabilities of the promoters were verified by flow cytometry and quantitative RT-PCR. Our results indicate that FUM-M shows dynamic behavior in the presence and absence of extrinsic factors. A correlation was also observed between the function of promoters, present in the lentiviral construct and the endogenous level of the Stra8 and c-kit mRNAs in the cells. In conclusion, we recommend this strategy, which needs further optimization of the constructs, as a beneficial and practical way to screen chemical inducers involved in cellular differentiation toward germ-like cells.

Inference about the number of contributors to a DNA mixture: Comparative analyses of a Bayesian network approach and the maximum allele count method.

In the forensic examination of DNA mixtures, the question of how to set the total number of contributors (N) presents a topic of ongoing interest. Part of the discussion gravitates around issues of bias, in particular when assessments of the number of contributors are not made prior to considering the genotypic configuration of potential donors. Further complication may stem from the observation that, in some cases, there may be numbers of contributors that are incompatible with the set of alleles seen in the profile of a mixed crime stain, given the genotype of a potential contributor. In such situations, procedures that take a single and fixed number contributors as their output can lead to inferential impasses. Assessing the number of contributors within a probabilistic framework can help avoiding such complication. Using elements of decision theory, this paper analyses two strategies for inference on the number of contributors. One procedure is deterministic and focuses on the minimum number of contributors required to 'explain' an observed set of alleles. The other procedure is probabilistic using Bayes' theorem and provides a probability distribution for a set of numbers of contributors, based on the set of observed alleles as well as their respective rates of occurrence. The discussion concentrates on mixed stains of varying quality (i.e., different numbers of loci for which genotyping information is available). A so-called qualitative interpretation is pursued since quantitative information such as peak area and height data are not taken into account. The competing procedures are compared using a standard scoring rule that penalizes the degree of divergence between a given agreed value for N, that is the number of contributors, and the actual value taken by N. Using only modest assumptions and a discussion with reference to a casework example, this paper reports on analyses using simulation techniques and graphical models (i.e., Bayesian networks) to point out that setting the number of contributors to a mixed crime stain in probabilistic terms is, for the conditions assumed in this study, preferable to a decision policy that uses categoric assumptions about N.

Comparative clinical study of different multiplex real time PCR strategies for the simultaneous differential diagnosis between extrapulmonary tuberculosis and focal complications of brucellosis

Background: Both brucellosis and tuberculosis are chronic-debilitating systemic granulomatous diseases with a high incidence in many countries in Africa, Central and South America, the Middle East and the Indian subcontinent. Certain focal complications of brucellosis and extrapulmonary tuberculosis are very difficult to differentiate clinically, biologically and radiologically. As the conventional microbiological methods for the diagnosis of the two diseases have many limitations, as well as being time-consuming, multiplex real time PCR (M RT-PCR) could be a promising and practical approach to hasten the differential diagnosis and improve prognosis. Methodology/Principal Findings: We designed a SYBR Green single-tube multiplex real-time PCR protocol targeting bcsp31 and the IS711 sequence detecting all pathogenic species and biovars of Brucella genus, the IS6110 sequence detecting Mycobacterium genus, and the intergenic region senX3-regX3 specifically detecting Mycobacterium tuberculosis complex. The diagnostic yield of the M RT-PCR with the three pairs of resultant amplicons was then analyzed in 91 clinical samples corresponding to 30 patients with focal complications of brucellosis, 24 patients with extrapulmonary tuberculosis, and 36 patients (Control Group) with different infectious, autoimmune or neoplastic diseases. Thirty-five patients had vertebral osteomyelitis, 21 subacute or chronic meningitis or meningoencephalitis, 13 liver or splenic abscess, eight orchiepididymitis, seven subacute or chronic arthritis, and the remaining seven samples were from different locations. Of the three pairs of amplicons (senX3-regX3+ bcsp3, senX3-regX3+ IS711 and IS6110+ IS711) only senX3-regX3+ IS711 was 100% specific for both the Brucella genus and M. tuberculosis complex. For all the clinical samples studied, the overall sensitivity, specificity, and positive and negative predictive values of the M RT-PCR assay were 89.1%, 100%, 85.7% and 100%, respectively, with an accuracy of 93.4%, (95% CI, 88.3—96.5%). Conclusions/Significance: In this study, a M RT-PCR strategy with species-specific primers based on senX3-regX3+IS711 sequences proved to be a sensitive and specific test, useful for the highly efficient detection of M. tuberculosis and Brucella spp in very different clinical samples. It thus represents an advance in the differential diagnosis between some forms of extrapulmonary tuberculosis and focal complications of brucellosis.

Predicting response and survival in chemotherapy-treated triple-negative breast cancer.

BACKGROUND In this study, we evaluated the ability of gene expression profiles to predict chemotherapy response and survival in triple-negative breast cancer (TNBC). METHODS Gene expression and clinical-pathological data were evaluated in five independent cohorts, including three randomised clinical trials for a total of 1055 patients with TNBC, basal-like disease (BLBC) or both. Previously defined intrinsic molecular subtype and a proliferation signature were determined and tested. Each signature was tested using multivariable logistic regression models (for pCR (pathological complete response)) and Cox models (for survival). Within TNBC, interactions between each signature and the basal-like subtype (vs other subtypes) for predicting either pCR or survival were investigated. RESULTS Within TNBC, all intrinsic subtypes were identified but BLBC predominated (55-81%). Significant associations between genomic signatures and response and survival after chemotherapy were only identified within BLBC and not within TNBC as a whole. In particular, high expression of a previously identified proliferation signature, or low expression of the luminal A signature, was found independently associated with pCR and improved survival following chemotherapy across different cohorts. Significant interaction tests were only obtained between each signature and the BLBC subtype for prediction of chemotherapy response or survival. CONCLUSIONS The proliferation signature predicts response and improved survival after chemotherapy, but only within BLBC. This highlights the clinical implications of TNBC heterogeneity, and suggests that future clinical trials focused on this phenotypic subtype should consider stratifying patients as having BLBC or not.

Confounding factors and genetic polymorphism in the evaluation of individual steroid profiling

In the fight against doping, steroid profiling is a powerful tool to detect drug misuse with endogenous anabolic androgenic steroids. To establish sensitive and reliable models, the factors influencing profiling should be recognised. We performed an extensive literature review of the multiple factors that could influence the quantitative levels and ratios of endogenous steroids in urine matrix. For a comprehensive and scientific evaluation of the urinary steroid profile, it is necessary to define the target analytes as well as testosterone metabolism. The two main confounding factors, that is, endogenous and exogenous factors, are detailed to show the complex process of quantifying the steroid profile within WADA-accredited laboratories. Technical aspects are also discussed as they could have a significant impact on the steroid profile, and thus the steroid module of the athlete biological passport (ABP). The different factors impacting the major components of the steroid profile must be understood to ensure scientifically sound interpretation through the Bayesian model of the ABP. Not only should the statistical data be considered but also the experts in the field must be consulted for successful implementation of the steroidal module.

From MuSIASEM theory to practice: report and reflections from field research in Kampot province, Cambodia

This document contains a report and summary of the field research activities in a rural community of rice farmers in Kampot province, Cambodia in 2011, which I conducted within the context of my PhD research at ICTA-UAB (Institute of Environmental Science and Technology, Autonomous University of Barcelona, Spain). The purpose of the field research was to gather data for a MuSIASEM analysis (Multi-Scale Integrated Analysis of Societal and Ecosystem Metabolism) at the village and household level, in order to analyze the multidimensional challenges that small farmers may face nowadays within the context of global rural change and declining access to land. While the literature on MuSIASEM offers a great variety of theoretical explanations and practical applications, there is little information available for students regarding the practical steps required for doing a MuSIASEM analysis at the local level. Within this context, this report offers not only a documentation of the field research design and data collection methods, but further provides a general overview on some organizational and preparative aspects, including some personal reflections, that one may face when preparing and conducting field research for MuSIASEM analysis. In summary, this document thus serves three objectives: (i) to assure methodological transparency for the future work, based on the collected data during field research, (ii) to share my personal experience on the preparative and practical steps required for field research and data collection for a MuSIASEM analysis at the local level, and (iii) to make available for the further interested reader some more detailed background information on the case study village.

Organizational resources and intrapreneurial activities: a cross-country study

The importance of entrepreneurship for social and economic growth is generally accepted. In addition, intrapreneurship or corporate entrepreneurship is recognized as one of the key elements for organizational development. In this context, corporate culture and, specifically, entrepreneurial competences are considered to be catalysts for intrapreneurship. The main purpose of this paper is to analyse the influence of resources and capabilities on the probability of becoming an intrapreneur. Using data obtained from the Global Entrepreneurship Monitor (GEM) for 39 countries, and a logistic model, the study shows that entrepreneurial resources and capabilities, such as previous entrepreneurial experience, entrepreneurial competences and the ability to detect business opportunities, influence intrapreneurial behaviour. The contributions of this research are both conceptual (advancing corporate entrepreneurship theory) and practical (relating to the design of policies to foster intrapreneurial activities).

Bayesian networks for evaluating forensic DNA profiling evidence: a review and guide to literature

Almost 30 years ago, Bayesian networks (BNs) were developed in the field of artificial intelligence as a framework that should assist researchers and practitioners in applying the theory of probability to inference problems of more substantive size and, thus, to more realistic and practical problems. Since the late 1980s, Bayesian networks have also attracted researchers in forensic science and this tendency has considerably intensified throughout the last decade. This review article provides an overview of the scientific literature that describes research on Bayesian networks as a tool that can be used to study, develop and implement probabilistic procedures for evaluating the probative value of particular items of scientific evidence in forensic science. Primary attention is drawn here to evaluative issues that pertain to forensic DNA profiling evidence because this is one of the main categories of evidence whose assessment has been studied through Bayesian networks. The scope of topics is large and includes almost any aspect that relates to forensic DNA profiling. Typical examples are inference of source (or, 'criminal identification'), relatedness testing, database searching and special trace evidence evaluation (such as mixed DNA stains or stains with low quantities of DNA). The perspective of the review presented here is not exclusively restricted to DNA evidence, but also includes relevant references and discussion on both, the concept of Bayesian networks as well as its general usage in legal sciences as one among several different graphical approaches to evidence evaluation.

An Illustrated Guide for Monitoring and Protecting Bridge Waterways Against Scour - Project TR-515 - Final Report, March 2006

This report is a well illustrated and practical Guide intended to aid engineers and engineering technicians in monitoring, maintaining, and protecting bridge waterways so as to mitigate or prevent scour from adversely affecting the structural performance of bridge abutments, piers, and approach road embankments. Described and illustrated here are the scour processes affecting the stability of these components of bridge waterways. Also described and illustrated are methods for monitoring waterways, and the various methods for repairing scour damage and protecting bridge waterways against scour. The Guide focuses on smaller bridges, especially those in Iowa. Scour processes at small bridges are complicated by the close proximity of abutments, piers, and waterway banks, such that scour processes interact in ways difficult to predict and for which reliable design relationships do not exist. Additionally, blockage by woody debris or by ice, along with changes in approach channel alignment, can have greater effects on pier and abutment scour for smaller bridges. These considerations tend to cause greater reliance on monitoring for smaller bridges. The Guide is intended to augment and support, as a source of information, existing procedures for monitoring bridge waterways. It also may prompt some adjustments of existing forms and reports used for bridge monitoring. In accord with increasing emphasis on effective management of public facilities like bridges, the Guide ventures to include an example report format for quantitative risk assessment applied to bridge waterways. Quantitative risk assessment is useful when many bridges have to be evaluated for scour risk and damage, and priorities need to be determined for repair and protection work. Such risk assessment aids comparison of bridges at risk. It is expected that bridge inspectors will implement the Guide as a concise, handy reference available back at the office. The Guide also likely may be implemented as an educational primer for new inspectors who have yet to become acquainted with waterway scour. Additionally, the Guide may be implemented as a part of process to check whether existing bridge-inspection forms or reports adequately encompass bridge-waterway scour.

Error and attack tolerance of layered complex networks.

Many complex systems may be described by not one but a number of complex networks mapped on each other in a multi-layer structure. Because of the interactions and dependencies between these layers, the state of a single layer does not necessarily reflect well the state of the entire system. In this paper we study the robustness of five examples of two-layer complex systems: three real-life data sets in the fields of communication (the Internet), transportation (the European railway system), and biology (the human brain), and two models based on random graphs. In order to cover the whole range of features specific to these systems, we focus on two extreme policies of system's response to failures, no rerouting and full rerouting. Our main finding is that multi-layer systems are much more vulnerable to errors and intentional attacks than they appear from a single layer perspective.