Best Practice for Providing Social Care and Support to People Living with Concurrent Sight Loss and Dementia: Professional Perspectives

Purpose-Approximately 100,000 people in the UK aged 75 and over have concurrent dementia and sight loss, but current understanding of their experiences, needs and preferences is limited. The purpose of this paper is to report on a research project that explored the provision of social care and support for older people with both conditions. Design/methodology/approach-The project was a collaboration between the universities of York, Worcester, Bournemouth and Cambridge, supported by the Thomas Pocklington Trust and the Housing and Dementia Research Consortium. Data for this paper were drawn from focus groups held in 2013 involving 47 professionals across the dementia, sight loss and housing sectors. Findings-Thematic analysis identified five main barriers to providing high-quality, cost-effective social care and support: time constraints; financial limitations; insufficient professional knowledge; a lack of joint working; and inconsistency of services. The requirements of dementia and sight loss often conflict, which can limit the usefulness of equipment, aids and adaptations. Support and information needs to address individual needs and preferences. Research limitations/implications-Unless professionals consider dementia and sight loss together, they are unlikely to think about the impact of both conditions and the potential of their own services to provide effective support for individuals and their informal carers. Failing to consider both conditions together can also limit the availability and accessibility of social care and support services. This paper is based on input from a small sample of self-selecting professionals across three geographical regions of England. More research is needed in this area. Practical implications-There are growing numbers of people living with concurrent dementia and sight loss, many of whom wish to remain living in their own homes. There is limited awareness of the experiences and needs of this group and limited provision of appropriate services aids/adaptations. A range of measures should be implemented in order to support independence and well-being for people living with both conditions and their family carers. These include increased awareness, improved assessment, more training and greater joint working. Social implications-People living with dementia or sight loss are at high risk of social isolation, increasingly so for those with both conditions. Services that take an inclusive approach to both conditions can provide crucial opportunities for social interaction. Extra care housing has the potential to provide a supportive, community-based environment that can help residents to maintain social contact. Originality/value-This paper adds much-needed evidence to the limited existing literature, and reflects the views of diverse professionals across housing, health and social care

Evolution of the rbcS gene family in Solanaceae: concerted evolution and gain and loss of introns, with a description of new statistical guidelines for determining the number of unique gene copies.

Thesis (Ph.D.)--University of Washington, 2014

Deciphering the mechanisms underlying the loss of BDNF neuroprotection in an Alzheimer’s disease model

Tese de mestrado, Neurociências, Faculdade de Medicina, Universidade de Lisboa, 2016

On absence: society’s return to barbarians

The problem of social exclusion is dealt here through the lens of a particularly radical social theory, that of autopoietic society by Niklas Luhmann. Here, exclusion is included in society, no longer as an issue for care, integration and therapy, but as a mechanism to show the importance of the visibility of exclusion. The inclusion of exclusion in autopoiesis is a far-reaching step that demands a revisiting of the concept of autopoietic society. This article proposes a radicalization of the concept on the basis of an acknowledgment of the impossibility of communication with the excluded. This acknowledgement conditions society from within. It is built upon the Luhmannian description of Barbarism as the included exclusion, and is further conceptualized as its excess, as a 'space of absence'. Within autopoiesis, absence is described as an aporetic rather than a paradoxical structure, a memento vanitas that irritates the system from within, constantly reminding it of its limitations.

How does a house remember? heritage-ising return migration in an Indonesian-Chinese house museum in Guangdong, PRC

This paper is an attempt to integrate heritage and museum studies through exploring the complex relationship between the materiality of architecture and social memories with a house museum of return migration in Guangdong, PRC as a case study. It unveils that the ongoing process of memory is intrinsically intertwined with spatial and temporal dimensions of the physical dwelling and built environment and the wider social-historical context and power relations shaping them. I argue that it is the house as ‘object of exhibit’ just as much as the exhibits inside the house that materialises the turbulent and traumatic migratory experience of Returned Overseas Chinese, embodies their memories and exposes the contested nature of museumification. By looking at the socially and geographically marginalised dwelling of return migrants, the house draws people’s attention to the often neglected importance of conceptual periphery in re-theorising what is often assumed to be the core of heritage value. It points to the necessity to integrate displaced, diasporic, transnational subjects to heritage and museum studies that have been traditionally framed within national and territorial boundaries.

Churchill as Chancellor of the Exchequer (1924–9) and the return to the gold standard

The general election of 29 October 1924 saw Winston Churchill return to Parliament as Constitutionalist MP for Epping after two years in the political wilderness. It also saw Stanley Baldwin swept back to Number 10 on a Conservative landslide. Speculation about whether Baldwin would cement Churchill’s drift from the Liberal fold by offering him office surfaced during the election campaign. Churchill nevertheless thought ‘it very unlikely that I shall be invited to join the Government, as owing to the size of the majority it will probably be composed only of impeccable Conservatives’. [ 1 ] Because of his anti-socialist credentials, his ability to reassure wavering Liberals through his opposition to protectionism – dropped by Baldwin after its rejection in the 1923 general election – and concern he could prove a rallying point for backbench malcontents, there was however much to commend giving Churchill a post. To his surprise, Baldwin offered Churchill the long-coveted office of Chancellor of the Exchequer, briefly held by his father before his ill-conceived resignation in 1887. Having arranged a meeting with his Labour predecessor, Philip Snowden, about outstanding business the new Chancellor set to work. Marking his political transition, a few days later Churchill resigned from the National Liberal Club.

Cross-Industry Product Diversification and Contagion in Risk and Return: The Case of Bank-Insurance and Insurance-Bank Takeovers

We investigate the impact of domestic/international bancassurance deals on the risk-return profiles of announcing and non-announcing banks and insurers within a GARCH model. Bank-insurance deals produce intra- and inter-industry contagion in both risk and return, with larger deals producing greater contagion. Bidder banks and peers experience positive abnormal returns, with the effects on insurer peers being stronger than those on bank peers. Insurance-bank deals produce insignificant excess returns for bidder and peer insurers and positive valuations for peer banks. Following the deal, the bank bidders’ idiosyncratic (systematic) risk falls (increases), while insurance bidders exhibit a lower systematic risk and maintain their idiosyncratic risk.

From syntagmatic to paradigmatic spatial zeroes: the loss of the preposition se in inner Asia Minor Greek

We trace the diachronic development of the preposition se in inner Asia Minor Greek from its use to mark a range of spatial functions to its ultimate loss and replacement by zero. We propose that, before spreading to all syntactic and semantic contexts, zero marking was contextually-dependent on the presence/absence of a prenominal genitive modifying the head noun of Ground-encoding NPs and on the presence/absence of Region-encoding postpositions. We attribute these developments to an informational load relief strategy aimed at producing more economical utterances as well as to language contact with Turkish, which favoured structural convergence on the adpositional level between the two languages.

Protein deiminases: new players in the developmentally regulated loss of neural regenerative ability

Spinal cord regenerative ability is lost with development, but the mechanisms underlying this loss are still poorly understood. In chick embryos, effective regeneration does not occur after E13, when spinal cord injury induces extensive apoptotic response and tissue damage. As initial experiments showed that treatment with a calcium chelator after spinal cord injury reduced apoptosis and cavitation, we hypothesized that developmentally regulated mediators of calcium-dependent processes in secondary injury response may contribute to loss of regenerative ability. To this purpose we screened for such changes in chick spinal cords at stages of development permissive (E11) and non-permissive (E15) for regeneration. Among the developmentally regulated calcium-dependent proteins identified was PAD3, a member of the peptidylarginine deiminase (PAD) enzyme family that converts protein arginine residues to citrulline, a process known as deimination or citrullination. This post-translational modification has not been previously associated with response to injury. Following injury, PAD3 up-regulation was greater in spinal cords injured at E15 than at E11. Consistent with these differences in gene expression, deimination was more extensive at the non-regenerating stage, E15, both in the gray and white matter. As deimination paralleled the extent of apoptosis, we investigated the effect of blocking PAD activity on cell death and deiminated-histone 3, one of the PAD targets we identified by mass-spectrometry analysis of spinal cord deiminated proteins. Treatment with the PAD inhibitor, Cl-amidine, reduced the abundance of deiminated-histone 3, consistent with inhibition of PAD activity, and significantly reduced apoptosis and tissue loss following injury at E15. Altogether, our findings identify PADs and deimination as developmentally regulated modulators of secondary injury response, and suggest that PADs might be valuable therapeutic targets for spinal cord injury.

Winston Churchill as Chancellor of the Exchequer (1924-9) and the Return to the Gold Standard

This revisits Churchill's decision, as Chancellor of the Exchequer 1924-29, to restore the Gold Standard in 1925. This is considered within the wider context of the overall aims of Churchill's policies, including his efforts to: tackle Anglo-American economic and financial relations in the aftermath of the Great War; address budgetary pressures; widen the tax base through innovations such as the Betting Duty; spread the social burden of taxes; and revive the economy, not least through his de-rating scheme.

Low-loss austempered ductile iron gears: experimental evaluation comparing materials and lubricants

An experimental study to evaluate the power dissipation of gears was performed. Three low-loss gear models were manufactured using standard 20° pressure angle tools. Austempered ductile iron (ADI) and 20MnCr5 carburized steel gears were tested in an FZG gear test machine using mineral, ester and polyalphaolephine (PAO)-based oils. The results compare power dissipation, the influence of different tooth flank geometries, materials and lubricants. This work concludes that conventional power-transmission gears can be replaced by these improved and more efficient low–loss models, which can be produced using common tools and that steel gears can be successfully replaced by austempered ductile iron gears.

Influence of grease formulation on thrust bearings power loss

The minimization of the power loss and the use of the biodegradable greases have attracting considerable attention. To compare the energetic performance of biodegradable lubricant greases, power loss tests were performed on a modified four-ball machine. A correlation between the grease formulation and rheology was established with its energetic performance

Estudo da Viabilidade Técnico-Económica de umm Sistema de Cogeração para um Complexo de Piscinas Interiores

A presente dissertação centrou-se no estudo técnico-económico de dois cenários futuros para a continuação de fornecimento de energia térmica a um complexo de piscinas existente na região do vale do Tâmega. Neste momento a central de cogeração existente excedeu a sua licença de utilização e necessita de ser substituída. Os dois cenários em estudo são a compra de uma nova caldeira, a gás natural, para suprir as necessidades térmicas da caldeira existente a fuelóleo, ou o uso de um sistema de cogeração compacto que poderá estar disponível numa empresa do grupo. No primeiro cenário o investimento envolvido é cerca de 456 640 € sem proveitos de outra ordem para além dos requisitos térmicos, mas no segundo cenário os resultados são bem diferentes, mesmo que tenha de ser realizado o investimento de 1 000 000 € na instalação. Para este cenário foi efetuado um levantamento da legislação nacional no que toca à cogeração, recolheram-se dados do edifício como: horas de funcionamento, número de utentes, consumos de energia elétrica, térmica, água, temperatura da água das piscinas, temperatura do ar da nave, assim como as principais características da instalação de cogeração compacta. Com esta informação realizou-se o balanço de massa e energia e criou-se um modelo da nova instalação em software de modelação processual (Aspen Plus® da AspenTech). Os rendimentos térmico e elétrico obtidos da nova central de cogeração compacta foram, respetivamente, de 38,1% e 39,8%, com uma percentagem de perdas de 12,5% o que determinou um rendimento global de 78%. A avaliação da poupança de energia primária para esta instalação de cogeração compacta foi de 19,6 % o que permitiu concluir que é de elevada eficiência. O modelo criado permitiu compreender as necessidades energéticas, determinar alguns custos associados ao processo e simular o funcionamento da unidade com diferentes temperaturas de ar ambiente (cenários de verão e inverno com temperaturas médias de 20ºC e 5ºC). Os resultados revelaram uma diminuição de 1,14 €/h no custo da electricidade e um aumento do consumo de gás natural de 62,47 €/h durante o período mais frio no inverno devido ao aumento das perdas provocadas pela diminuição da temperatura exterior. Com esta nova unidade de cogeração compacta a poupança total anual pode ser, em média, de 267 780 € admitindo um valor para a manutenção de 97 698 €/ano. Se assim for, o projeto apresenta um retorno do investimento ao fim de 5 anos, com um VAL de 1 030 430 € e uma taxa interna de rentabilidade (TIR) de 14% (positiva, se se considerar a taxa de atualização do investimento de 3% para 15 anos de vida). Apesar do custo inicial ser elevado, os parâmetros económicos mostram que o projeto tem viabilidade económica e dará lucro durante cerca de 9 anos.

Effect of sialic acid loss on dendritic cell maturation

Sialic acids are key structural determinants and contribute to the functionality of a number of immune cell receptors. Previously, we demonstrated that differentiation of human dendritic cells (DCs) is accompanied by an increased expression of sialylated cell surface structures, putatively through the activity of the ST3Gal.I and ST6Gal.I sialyltransferases. Furthermore, DC endocytosis was reduced upon removal of the cell surface sialic acid residues by neuraminidase. In the present work, we evaluate the contribution of the sialic acid modifications in DC maturation. We demonstrate that neuraminidase-treated human DCs have increased expression of major histocompatibility complex (MHC) and costimulatory molecules, increased gene expression of specific cytokines and induce a higher proliferative response of T lymphocytes. Together, the data suggest that clearance of cell surface sialic acids contributes to the development of a T helper type 1 proinflammatory response. This postulate is supported by mouse models, where elevated MHC class II and increased maturation of specific DC subsets were observed in DCs harvested from ST3Gal.I(-/-) and ST6Gal.I(-/-) mice. Moreover, important qualitative differences, particularly in the extent of reduced endocytosis and in the peripheral distribution of DC subsets, existed between the ST3Gal.I(-/-) and ST6Gal.I(-/-) strains. Together, the data strongly suggest not only a role of cell surface sialic acid modifications in maturation and functionality of DCs, but also that the sialic acid linkages created by different sialyltransferases are functionally distinct. Consequently, with particular relevance to DC-based therapies, cell surface sialylation, mediated by individual sialyltransferases, can influence the immunogenicity of DCs upon antigen loading.