915 resultados para Directions cardinales
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Monoclonal antibodies specific for selected species complexes of Leishmania have been employed for the characterization of several representative strains of Leishmania isolated from different hosts and localities in the Americas. In the past 15 years, data have been accumulated concerning (i) the specificities of a number of these monoclonal antibodies and (ii) the antigenic variation (level of the expressed antigenic determinants) occurring among New World Leishmania species or strain variants as recognized by the monoclonal antibodies. This report is an attempt to summarize in brief the data accumulated to date on these points and to indicate the directions for future applications of these specific monoclonal antibodies for identification of leishmanial isolates.
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Els objectius estan orientats cap a l’assoliment dels criteris de qualitat i la seva adaptació a les característiques de la titulació. És a dir, en quina mesura les diferents activitats docents permeten assolir les competències definides en la titulació. En aquest sentit, a continuació es relacionen els objectius plantejats: 1. Fer el seguiment de la docència de les dues assignatures d’estudi del projecte. 2. Construir un protocol d’assegurament de la qualitat docent, en el marc de la titulació, que permeti el seguiment i l’aplicació a la totalitat de la titulació. 3. Establir els processos de control i assegurament de la qualitat docent segons els criteris d’aprenentatge de Bolonya. 4. Aquests objectius hauran de ser desenvolupats durant la docència de les matèries objecte d’estudi. Els procediments que es presenten en aquest treball se centren en l’avaluació experimental de dos indicadors centrals en cada una de les assignatures de la prova. Els resultats aconseguits en aquest projecte dintre de la Prova Pilot de la titulació de Publicitat i Relacions Públiques ens porten cap a dues direccions. Primerament, les primeres proves i els indicis obtinguts fins al moment permeten determinar que l’aplicació de la metodologia Bolonya demostra tenir una major potència docent en una de les assignatures analitzades “Introducció a la creativitat publicitària”, i que, a més, identifica el caràcter d’estudiants que més rendiment d’aprenentatge en treuen. En l’altra assignatura, els resultats encara no són concloents, tot i que s’endevina que manté el ritme de bons resultats que ja es mostraven d’inici. En segon lloc, els resultats analitzats permeten pensar que l’ús de la metodologia Bolonya no implica cap detriment docent i a més a més, permet treballar de manera millor les matèries. La present recerca, doncs, quantifica en quin grau s’estableix la progressió d’aprenentatge amb les activitats docents en la nova metodologia Bolonya expressat en aquest valor de potència docent.
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Astrocytes play a central role in the brain by regulating glutamate and extracellular potassium concentrations ([K+]0), both released by neurons into the extracellular space during neuronal activity. Glutamate uptake is driven by the inwardly directed sodium gradient across the astrocyte membrane and involves the influx of three sodium ions and one proton and the efflux of one K+ ion per glutamate molecule. The glutamate transport induced rise in intracellular sodium stimulates the Na+/K+-ATPase which leads to significant energetic costs in astrocytes. To evaluate how these two fundamental functions of astrocytes, namely glutamate transport and K+ buffering, which are directly associated with neuronal activity, coexist and if they influence each other, in this thesis work we examined different cellular parameters of astrocytes. We therefore investigated the impact of altered [K+]0 on glutamate transporter activity. To assess this question we measured intracellular sodium fluctuations in mouse primary cultured astrocytes using dynamic fluorescence imaging. We found that glutamate uptake was tightly modulated both in amplitude and kinetics by [K+]0. Elevated [K+]0 strongly decreased glutamate transporter activity, with significant consequences on the cells energy metabolism. To ultimately evaluate potential effects of [K+]0 and glutamate on the astrocyte mitochondrial energy production we extended these studies by investigating their impact on the cytosolic and mitochondrial pH. We found that both [K+],, and glutamate strongly influenced cytosolic and mitochondrial pH, but in opposite directions. The effect of a simultaneous application of K+ and glutamate, however, did not fit with the arithmetical sum of each individual effects, suggesting that an additional non¬linear process is involved. We also investigated the impact of [K+]0 and glutamate transport, respectively, on intracellular potassium concentrations ([K+]0 in cultured astrocytes by characterizing and applying a newly developed Insensitive fluorescent dye. We observed that [K+]i followed [K+]0 changes in a nearly proportional way and that glutamate superfusion caused a reversible, glutamate-concentration dependent drop of [K+],, Our study shows the powerful influence of [K+]u on glutamate capture. These findings have strong implications for our understanding of the tightly regulated interplay between astrocytes and neurons in situations where [K+]0 undergoes large activity-dependent fluctuations. However, depending on the extent of K+ versus glutamate extracellular rise, energy metabolism in astrocytes will be differently regulated. Moreover, the novel insights obtained during this thesis work help understanding some of the underlying processes that prevail in certain pathologies of central nervous system, such as epilepsy and stroke. These results will possibly provide a basis for the development of novel therapeutic strategies. -- Les astrocytes jouent un rôle central dans le cerveau en régulant les concentrations de potassium (K+) et de glutamate, qui sont relâchés par les neurones dans l'espace extracellulaire lorsque ceux- ci sont actifs. La capture par les astrocytes du glutamate est un processus secondairement actif qui implique l'influx d'ions sodium (Na+) et d'un proton, ainsi que l'efflux d'ions K+, ce processus entraîne un coût métabolique important. Nous avons évalué comment ces fonctions fondamentales des astrocytes, la régulation du glutamate et du K+ extracellulaire, qui sont directement associés à l'activité neuronale, coexistent et si elles interagissent, en examinant différents paramètres cellulaires. Dans ce projet de thèse nous avons évalué l'impact des modifications de la concentration de potassium extracellulaire ([K+],,) sur le transport du glutamate. Nous avons mesuré le transport du glutamate par le biais des fluctuations internes de Na+ grâce à un colorant fluorescent en utilisant de l'imagerie à fluorescence dynamique sur des cultures primaires d'astrocytes. Nous avons trouvé que la capture du glutamate était étroitement régulée par [K+]0 aussi bien dans son amplitude que dans sa cinétique. Par la suite, nous avons porté notre attention sur l'impact de [K+]0 et du glutamate sur le pH cytosolique et mitochondrial de l'astrocyte dans le but, in fine, d'évaluer les effets potentiels sur la production d'énergie par la mitochondrie. Nous avons trouvé qu'autant le K+ que le glutamate, de manière individuelle, influençaient fortement le pH, cependant dans des directions opposées. Leurs effets individuels, ne peuvent toutefois pas être additionnés ce qui suggère qu'un processus additionnel non-linéaire est impliqué. En appliquant une nouvelle approche pour suivre et quantifier la concentration intracellulaire de potassium ([K+]0 par imagerie à fluorescence, nous avons observé que [K+]i suivait les changements de [K+]0 de manière quasiment proportionnelle et que la superfusion de glutamate induisait un décroissement rapide et réversible de [K+]i, qui dépend de la concentration de glutamate. Notre étude démontre l'influence de [K+]0 sur la capture du glutamate. Ces résultats permettent d'améliorer notre compréhension de l'interaction entre astrocytes et neurones dans des situations où [K+]0 fluctue en fonction de l'activité neuronale. Cependant, en fonction de l'importance de l'augmentation extracellulaire du K+ versus le glutamate, le métabolisme énergétique des astrocytes va être régulé de manière différente. De plus, les informations nouvelles que nous avons obtenues durant ce travail de thèse nous aident à comprendre quelques- uns des processus sous-jacents qui prévalent dans certaines pathologies du système nerveux central, comme par exemple l'épilepsie ou l'accident vasculaire cérébral. Ces informations pourront être importantes à intégrer dans la cadre du développement de nouvelles stratégies thérapeutiques.
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The authors present morphogenetic and biomechanical approaches on the concept of the Schistosoma mansoni granulomas, considering them as organoid structures that depend on cellular adhesion and sorting, forming rearrangement into hierarchical concentric layers, creating tension-dependent structures, aiming to acquire round form, since this is the minimal energy form, in which opposing forces pull in equally from all directions and are in balance. From the morphogenetic point of view, the granulomas function as little organs, presenting maturative and involutional stages in their development with final disappearance (pre-granulomatous stages, subdivided in: weakly and/or initial reactive and exudative; granulomatous stages: exudative-productive, productive and involutional). A model for the development of granulomas was suggested, according to the following stages: encapsulating, focal histolysis, fiber production, orientation and compacting and involution and desintegration. The authors concluded that schistosomal granuloma is not a tangled web of individual cells and fibers, but an organized structure composed by host and parasite components, which is not formed to attack the miracidia, but functions as an hybrid interface between two different phylogenetic beings.
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Power is a fundamental force in social relationships and is pervasive throughout various types of interactions. Although research has shown that the possession of power can change the powerholder, the full extent of power's consequences on individuals' decision making capabilities and social interactions within organizations is not fully understood. The goal of this paper is to review, synthesize, and critique the literature on power with a focus on its organizational and managerial implications. Specifically, we propose a definition of power that takes into account its three defining characteristics-having the discretion and means to enforce one's will-and summarize the extant literature on how power influences individuals' thoughts, emotions, and actions both in terms of prosocial and antisocial outcomes. In addition, we highlight important moderators of power and describe ways in which it can be studied in a more rigorous manner by examining methodological issues and pitfalls with regard to its measurement and manipulation. We also provide future research directions to motivate and guide the study of power by management scholars. Our desire is to present a thorough and parsimonious account of power's influence on individuals within an organizational context, as well as provide a foundation that scholars can build upon as they continue to make consequential contributions to the study of power.
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Projecte de recerca elaborat a partir d’una estada a la Università degli studi di Siena, Italy , entre 2007 i 2009. El projecte ha consistit en un estudi de la formalització lògica del raonament en presència de vaguetat amb els mètodes de la Lògica Algebraica i de la Teoria de la Prova. S'ha treballat fonamental en quatre direccions complementàries. En primer lloc, s'ha proposat un nou plantejament, més abstracte que el paradigma dominant fins ara, per l'estudi dels sistemes de lògica borrosa. Fins ara en l'estudi d'aquests sistemes l'atenció havia recaigut essencialment en l'obtenció de semàntiques basades en tnormes contínues (o almenys contínues per l'esquerra). En primer nivell de major abstracció hem estudiat les propietats de completesa de les lògiques borroses (tant proposicionals com de primer ordre) respecte de semàntiques definides sobre qualsevol cadena de valors de veritat, no necessàriament només sobre l'interval unitat dels nombres reals. A continuació, en un nivell encara més abstracte, s’ha pres l'anomenada jerarquia de Leibniz de la Lògica Algebraica Abstracta que classifica tots els sistemes lògics amb un bon comportament algebraic i s'ha expandit a una nova jerarquia (que anomenem implicacional) que permet definir noves classes de lògiques borroses que contenen quasi totes les conegudes fins ara. En segon lloc, s’ha continuat una línia d'investigació iniciada els darrers anys consistent en l'estudi de la veritat parcial com a noció sintàctica (és a dir, com a constants de veritat explícites en els sistemes de prova de les lògiques borroses). Per primer cop, s’ha considerat la semàntica racional per les lògiques proposicionals i la semàntica real i racional per les lògiques de primer ordre expandides amb constants. En tercer lloc, s’ha tractat el problema més fonamental del significat i la utilitat de les lògiques borroses com a modelitzadores de (part de) els fenòmens de la vaguetat en un darrer article de caràcter més filosòfic i divulgatiu, i en un altre més tècnic en què defensem la necessitat i presentem l'estat de l'art de l'estudi de les estructures algèbriques associades a les lògiques borroses. Finalment, s’ha dedicat la darrera part del projecte a l'estudi de la complexitat aritmètica de les lògiques borroses de primer ordre.
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In the PhD thesis “Sound Texture Modeling” we deal with statistical modelling or textural sounds like water, wind, rain, etc. For synthesis and classification. Our initial model is based on a wavelet tree signal decomposition and the modeling of the resulting sequence by means of a parametric probabilistic model, that can be situated within the family of models trainable via expectation maximization (hidden Markov tree model ). Our model is able to capture key characteristics of the source textures (water, rain, fire, applause, crowd chatter ), and faithfully reproduces some of the sound classes. In terms of a more general taxonomy of natural events proposed by Graver, we worked on models for natural event classification and segmentation. While the event labels comprise physical interactions between materials that do not have textural propierties in their enterity, those segmentation models can help in identifying textural portions of an audio recording useful for analysis and resynthesis. Following our work on concatenative synthesis of musical instruments, we have developed a pattern-based synthesis system, that allows to sonically explore a database of units by means of their representation in a perceptual feature space. Concatenative syntyhesis with “molecules” built from sparse atomic representations also allows capture low-level correlations in perceptual audio features, while facilitating the manipulation of textural sounds based on their physical and perceptual properties. We have approached the problem of sound texture modelling for synthesis from different directions, namely a low-level signal-theoretic point of view through a wavelet transform, and a more high-level point of view driven by perceptual audio features in the concatenative synthesis setting. The developed framework provides unified approach to the high-quality resynthesis of natural texture sounds. Our research is embedded within the Metaverse 1 European project (2008-2011), where our models are contributting as low level building blocks within a semi-automated soundscape generation system.
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Résumé Contexte et objectifs Les activités de recherche appliquée et développement (Ra&D) font partie du mandat de prestations des hautes écoles spécialisées (HES) prescrit par la loi. Néanmoins la tradition, le type et l'importance de la recherche varient fortement en fonction des domaines d'études. Il en va de même pour les liens avec les autres domaines de prestations que sont l'enseignement, la formation continue et les prestations de services. Les activités de Ra&D dans chaque HES s'inscrivent dans la tension entre l'orientation pratique (qui signifie le plus souvent une orientation vers le marché économique) et l'orientation vers la science (signe de leur rattachement au système scientifique). Il en découle des conflits d'intérêts entre les critères de qualité du « succès sur le marché » et de la « réputation scientifique ». En 2005, sur mandat de la Commission pour la technologie et l'innovation (CTI), B. Lepori et L. Attar (2006) ont mené une étude visant à examiner plus particulièrement les stratégies de recherche et l'organisation de la recherche au sein des hautes écoles spécialisées. Aujourd'hui, six ans plus tard, la phase de mise sur pied est en grande partie terminée. En lançant une nouvelle étude, l'Office fédéral de la formation professionnelle et de la technologie (OFFT) et la Commission fédérale des hautes écoles spécialisées (CFHES) souhaitaient faire le point sur les activités de recherche des HES, c'està- dire examiner les résultats des stratégies et de l'organisation de cette phase. Cette étude s'articule principalement autour de l'état actuel de la recherche, de ses problèmes et de ses perspectives. Structure de l'étude La recherche dans les HES se caractérise par différents facteurs d'influence (cultures disciplinaires, traditions, ancrage dans les régions linguistiques, structures organisationnelles, gouvernance, stratégies de positionnement, personnel, etc.). Dans la présente étude, ces facteurs sont systématiquement examinés selon deux dimensions: le « domaine d'études » et la « haute école spécialisée». L'analyse repose notamment sur l'exploitation de documents et de données. Mais cette étude se fonde principalement sur les entretiens menés avec les représentants des HES à différents niveaux de responsabilités. Les hautes écoles spécialisées (HES) Les entretiens avec les directions des HES ainsi que l'exploitation des données et des documents mettent en évidence la grande diversité des sept HES suisses de droit public dans leur structure, leurs combinaisons de domaines d'études et leurs orientations. Les modes de financement de la recherche varient fortement entre les HES. Concrètement, les sources de financement ne sont pas les mêmes d'une HES à l'autre (contributions des organes responsables, fonds de tiers, etc.). Les degrés et formes du pilotage concernant les contenus de la recherche diffèrent également dans une large mesure (définition de pôles de recherche, soutien cumulatif à l'acquisition de fonds de tiers), de même que les stratégies en matière de recrutement et d'encouragement du personnel. La politique de chaque HES implique des tensions et des problèmes spécifiques. Les domaines d'études Sur les dix domaines d'études, quatre ont été choisis à titre d'exemples pour des études approfondies : Technique et technologies de l'information (TI), Economie et services, Travail social, Musique, arts de la scène et autres arts. Chaque domaine d'études a été examiné à chaque fois dans deux HES. Cette méthode permet de relever les différences et les similitudes. Les résultats confirment qu'il existe des différences importantes à bien des égards entre les domaines d'études évalués. Ces différences concernent la position dans le système des hautes écoles, le volume des activités de recherche, l'importance de la recherche au sein des HES, la tradition, l'identité et l'orientation. Elles se retrouvent par ailleurs dans les buts et la place de la Ra&D dans les domaines d'études concernés. Il ressort toutefois qu'il n'y a pas lieu de parler d'une dichotomie entre les « anciens » et les « nouveaux » domaines d'études : Technique, économie et design (TED) d'une part et Santé, social et arts (SSA) d'autre part. Il semble plus pertinent de désigner le domaine d'études 4/144 Technique et TI comme le domaine dominant auquel se référent le pilotage et le financement des HES, que ce soit implicitement ou explicitement. Cadre homogène et espaces hétérogènes Le pilotage et le financement de la Ra&D au sein des hautes écoles spécialisées s'inscrivent dans un modèle-cadre fixé à l'échelle fédérale et principalement axé sur le domaine d'études Technique. Ce modèle-cadre se caractérise par un apport élevé de fonds de tiers (notamment les subventions de la CTI et les fonds privés) et des incitations en faveur de ce mode de financement, par une orientation vers le marché et par un haut degré d'autonomie des établissements partenaires/départements et instituts. Par comparaison avec les hautes écoles universitaires, les HES affichent notamment un faible niveau de financement de base dans le secteur Ra&D. Cet état de fait est certes compatible avec la forme actuelle du financement par la CTI, mais pas avec les règles de financement du Fonds national suisse (FNS). Un financement principalement basé sur les fonds de tiers signifie par ailleurs que l'orientation du contenu de la recherche et la définition de critères de qualité sont confiées à des instances externes, notamment aux mandants et aux institutions d'encouragement de la recherche. Il apparaît en dernier lieu qu'un tel modèle-cadre ne favorise pas les politiques visant à la constitution de pôles de recherche, l'obtention d'une taille critique, et la mise en place d'une coordination. Ces résultats concernent tous les domaines d'études sans avoir pour autant les mêmes conséquences : les domaines d'études se prêtant dans une faible mesure à l'acquisition de fonds de tiers sur des marchés économiques (dans cette étude, il s'agit essentiellement de la Musique, arts de la scène et autres arts, mais également du Travail social dans certains cas) ont plus de difficultés à répondre aux attentes énoncées en termes de succès et de profit. Les HES modifient plus ou moins le modèle-cadre en élaborant elles-mêmes des modèles d'organisation qui prennent en compte leur combinaison de domaines d'études et soutiennent leurs propres orientations et positionnements stratégiques. La combinaison de domaines d'études hétérogènes et de politiques différentes au sein des HES se traduit par une complexité du système des HES, beaucoup plus importante que ce que généralement supposée. De plus, au regard des connaissances lacunaires sur les structures « réelles » de gouvernance des HES, il n'est quasiment pas possible de comparer directement les hautes écoles spécialisées entre elles. Conclusions et recommandations Le principal constat qui ressort d'un ensemble de conclusions et de recommandations des auteurs est que le secteur Ra&D dans les HES doit être plus explicitement évalué en fonction des spécificités des domaines d'études, à savoir du rôle de la recherche pour l'économie et la société, des différences entre les marchés (économiques) correspondants et de l'importance de la Ra&D pour les objectifs visés. L'étude montre clairement qu'il n'y a pas à proprement parler une seule et unique recherche au sein des hautes écoles spécialisées et que la notion de « recherche appliquée » ne suffit ni comme description ni, par conséquence, comme critère d'identité commun. Partant de ce constat, nous recommandons de revoir le mode de financement de la recherche dans les HES et d'approfondir le débat sur les structures de gouvernance sur l'orientation de la Ra&D (et notamment sur les critères de qualité appliqués), de même que sur l'autonomie et la coordination. Les recommandations constituent des points de discussion et n'engagent aucunement l'OFFT ou la CFHES.
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1 6 STRUCTURE OF THIS THESIS -Chapter I presents the motivations of this dissertation by illustrating two gaps in the current body of knowledge that are worth filling, describes the research problem addressed by this thesis and presents the research methodology used to achieve this goal. -Chapter 2 shows a review of the existing literature showing that environment analysis is a vital strategic task, that it shall be supported by adapted information systems, and that there is thus a need for developing a conceptual model of the environment that provides a reference framework for better integrating the various existing methods and a more formal definition of the various aspect to support the development of suitable tools. -Chapter 3 proposes a conceptual model that specifies the various enviromnental aspects that are relevant for strategic decision making, how they relate to each other, and ,defines them in a more formal way that is more suited for information systems development. -Chapter 4 is dedicated to the evaluation of the proposed model on the basis of its application to a concrete environment to evaluate its suitability to describe the current conditions and potential evolution of a real environment and get an idea of its usefulness. -Chapter 5 goes a step further by assembling a toolbox describing a set of methods that can be used to analyze the various environmental aspects put forward by the model and by providing more detailed specifications for a number of them to show how our model can be used to facilitate their implementation as software tools. -Chapter 6 describes a prototype of a strategic decision support tool that allow the analysis of some of the aspects of the environment that are not well supported by existing tools and namely to analyze the relationship between multiple actors and issues. The usefulness of this prototype is evaluated on the basis of its application to a concrete environment. -Chapter 7 finally concludes this thesis by making a summary of its various contributions and by proposing further interesting research directions.
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Järvholm and Co-workers (2009) proposed a conceptual model for research on working life. Models are powerful communication and decision tools. This model is strongly unidirectional and does not cover the mentioned interactions in the arguments.With help of a genealogy of work and of health it is shown that work and health are interactive and have to be analysed on the background of society.Key words: research model, work, health, occupational health, society, interaction, discussion paperRemodellierung der von Järvholm et al. (2009) vorgeschlagenen Forschungsperspektiven in Arbeit und GesundheitJärvholm und Kollegen stellten 2009 ein konzeptionelles Modell für die Forschung im Bereich Arbeit und Gesundheit vor. Modelle stellen kraftvolle Kommunikations- und Entscheidungsinstrumente dar. Die Einflussfaktoren im Modell verlaufen jedoch nur in einer Richtung und bilden die interaktiven Argumente im Text nicht ab. Mit Hilfe einer Genealogie der Begriffe Arbeit und Gesundheit wird aufgezeigt, dass Arbeit und Gesundheit sich gegenseitig beeinflussen und nur vor dem Hintergrund der jeweiligen gesellschaftlichen Kontextfaktoren zu analysieren sind.Introduction : After an interesting introduction about the objectives of research on working life, Järvholm and Co-workers (2009) manage to define a conceptual model for working life research out of a small survey of Occupational Safety and Health (OSH) definitions. The strong point of their model is the entity 'working life' including personal development, as well as career paths and aging. Yet, the model Järvholm et al. (2009) propose is strangely unidirectional; the arrows point from the population to working life, from there to health and to disease, as well as to productivity and economic resources. The diagram only shows one feed-back loop: between economic resources and health. We all know that having a chronic disease condition influences work and working capacity. Economic resources have a strong influence on work, too. Having personal economic resources will influence the kind of work someone accepts and facilitate access to continuous professional education. A third observation is that society is not present in the model, although this is less the case in the arguments. In fact, there is an incomprehensible gap between the arguments brought forth by Järvholm and co-workers and their reductionist model.Switzerland has a very low coverage of occupational health specialists. Switzerland is a long way from fulfilling the WHO's recommendations on workers' access to OSH services as described in its Global plan of action. The Institute for Work and Health (IST) in Lausanne is the only organisation which covers the major domains of OSH research that are occupational medicine, occupational hygiene, ergonomic and psychosocial research. As the country's sole occupational health institution we are forced to reflect the objectives of working life research so as not to waste the scare resources available.I will set out below a much shortened genealogy of work and of health, with the aim of extending Järvholm et al's (2009) analyses on the perspectives of working life research in two directions. Firstly towards the interactive nature of work and health and the integration of society, and secondly towards the question of what working life means or where working life could be situated.Work, as we know it today - paid work regulated by a contract as the basis for sustaining life and as a base for social rights - was born in modern era. Therefore I will start my genealogy in the pre-modern era, focus on the important changes that occurred during industrial revolution and the modern era and end in 2010 taking into account the enormous transformations of the past 20-30 years. I will put aside some 810 years of advances in science and technology that have expanded the world's limits and human understanding, and restrict my genealogy to work and to health/body implicating also the societal realm. [Author]
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The report presents evidence on a range of factors affecting disparity between mental and physical health, and includes case studies and examples of good practice to illustrate some of the key issues and solutions. It should be seen as the first stage of an on-going process over the next 5"10 years that will deliver parity for mental health and make whole-person care a reality. It builds on the Implementation Framework for the Mental Health Strategy in providing further analysis of why parity does not currently exist, and the actions required to bring it about. A parity approach should enable NHS and local authority health and social care services to provide a holistic, whole person response to each individual, whatever their needs, and should ensure that all publicly funded services, including those provided by private organisations, give people's mental health equal status to their physical health needs. Central to this approach is the fact that there is a strong relationship between mental health and physical health, and that this influence works in both directions. Poor mental health is associated with a greater risk of physical health problems, and poor physical health is associated with a greater risk of mental health problems. Mental health affects physical health and vice versa. The report makes a series of key recommendations for the UK government, policy-makers and health professionals. Recommendations include: The government and the NHS Commissioning Board should work together to give people equivalent levels of access to treatment for mental health problems as for physical health problems, agreed standards for waiting times, and agreed standards for emergency/crisis mental healthcare. Action to promote good mental health and to address mental health problems needs to start at the earliest stage of a person's life and continue throughout the life course. Preventing premature mortality " there must be a major focus on improving the physical health of people with mental health problems. Public health programmes must include a focus on the mental health dimension of issues commonly considered as physical health concerns, such as smoking, obesity and substance misuse. Commissioners need to regard liaison doctors (who work across physical and mental healthcare) as an absolute necessity rather than an optional luxury. NHS and social care commissioners should commission liaison psychiatry and liaison physician services to drive a whole-person, integrated approach to healthcare in acute, secure, primary care and community settings, for all ages. Mental health services and mental health research must receive funding that reflects the prevalence of mental health problems and their cost to society. Mental illness is responsible for the largest proportion of the disease burden in the UK (22.8%), larger than that of cardiovascular disease (16.2%) or cancer (15.9%). However, only 11% of the NHS budget was spent on NHS services to treat mental health problems for all ages during 2010/11. Culture, attitudes and stigma " zero-tolerance policies in relation to discriminatory attitudes or behaviours should be introduced in all health settings to help combat the stigma that is still attached to mental illness within medicine. Political and managerial leadership is required at all levels. There should be a mechanism at national level for driving a parity approach to relevant policy areas across government; all local councils should have a lead councillor for mental health; all providers of specialist mental health services should have a board-level lead for physical health and all providers of physical healthcare services should have a board-level lead for mental health. The General Medical Council (GMC) and Nursing and Midwifery Council (NMC) should consider how medical and nursing study and training could give greater emphasis to mental health. Mental and physical health should be integrated within undergraduate medical education.This resource was contributed by The National Documentation Centre on Drug Use.
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Dementia and its most common cause, Alzheimer’s disease, affect memory and occur predominantly in the elderly. Dementia has become increasingly prevalent in the world as health has improved and life expectancy has increased. However, the fields of clinical care have not responded adequately to develop diagnostic tools and treatments for this rapidly increasing group of conditions. While scientists search for cures for the numerous causes of dementia, improvement of diagnostic measures are needed now and should begin with screening elderly populations for memory difficulties and other cognitive problems. This review examines the history of cognitive screening tests, the numerous excellent tests that are currently available and ready for use, and directions and methods that will lead to progressively better evaluations.
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Abstract : The Wiskott-Aldrich Syndrome (WAS) is an X-linked recessive human primary immunodeficiency. It is caused by mutations in the gene encoding the hermatopoietic specific regulator of the actin cytoskeleton Wiskott-Aldrich Syndrome Protein (WASP). Importantly, a majority of affected patients develop autoimmunity including an inflammatory bowel disease (IBD)-like disease. WASP deficient mice share many similarities with the human WAS. One of these similarities is the spontaneous development of colitis. I have focused my dissertation studies on the pathogenesis of colitis in WASP deficient mice. Prior work from our laboratory had shown that lymphocytes were required and that CD4+ T cells sufficient for colitis development. This colitis was associated with a predominant Th2-cytokine skewing. I have contributed in exploring whether the Th2 cytokine IL-4 plays a role in disease maintenance. Using two approaches to neutralize IL-4, we found that this cytokine plays a role in disease maintenance. Natural CD4*CD25*Foxp3* regulatory T cells (nTreg cells) have been implicated in the pathogenesis of several autoimmune disorders. We found that WASP deficient mice have reduced nTreg cell numbers in peripheral lymphoid organs. This was associated with functional defects in suppressing T cell proliferation and preventing colitis induced by transfer of naïve T cells into SCID recipient, which lack lymphocytes. WASP deficiency affected homing of nTreg cells to lymphoid compartments, IL-2-mediated activation and secretion of the immunomodulatory cytokine IL-10. Finally, we could prevent colitis onset via adoptive transfer of WT nTreg cells prior to colitis development. This suggests that nTreg cells dysfunction is one of the mechanisms underlying colitis development in WASP deficient mice. Future directions will aim at deciphering the role of other immune cell types, the bacterial flora, and various cytokines in colitis development in this murine model of colitis. In addition, we believe that colitis in WASP deficient mice could serve as a useful tool to evaluate nTreg cells manipulation as novel therapeutic approach for IBD.
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The PHA Corporate Business Plan 2011-2012 is based on the four core goals and the common themes from the Corporate Strategy 2011-2015 and sets out a corporate picture of how the goals will be taken forward in year one (2011-2012) in line with existing AMT and board direction.�All Directorates were involved in developing the Corporate Business Plan and it reflects the content of each of the Directorate business plans.�It identifies a number of measurable indicators taken from the DHSSPS Commissioning Directions 2011-2012, as well as from each of the Directorate business plans.The Corporate Business Plan was approved by AMT on 1 November and by the PHA board on 17 November. Quarterly monitoring reports on progress against the indicators will be brought to the PHA board.