The design and implementation of a study to investigate the effectiveness of community vs hospital eye service follow-up for patients with neovascular age-related macular degeneration with quiescent disease

Introduction
Standard treatment for neovascular age-related macular degeneration (nAMD) is intravitreal injections of anti-VEGF drugs. Following multiple injections, nAMD lesions often become quiescent but there is a high risk of reactivation, and regular review by hospital ophthalmologists is the norm. The present trial examines the feasibility of community optometrists making lesion reactivation decisions.

Methods
The Effectiveness of Community vs Hospital Eye Service (ECHoES) trial is a virtual trial; lesion reactivation decisions were made about vignettes that comprised clinical data, colour fundus photographs, and optical coherence tomograms displayed on a web-based platform. Participants were either hospital ophthalmologists or community optometrists. All participants were provided with webinar training on the disease, its management, and assessment of the retinal imaging outputs. In a balanced design, 96 participants each assessed 42 vignettes; a total of 288 vignettes were assessed seven times by each professional group.The primary outcome is a participant's judgement of lesion reactivation compared with a reference standard. Secondary outcomes are the frequency of sight threatening errors; judgements about specific lesion components; participant-rated confidence in their decisions about the primary outcome; cost effectiveness of follow-up by optometrists rather than ophthalmologists.

Discussion
This trial addresses an important question for the NHS, namely whether, with appropriate training, community optometrists can make retreatment decisions for patients with nAMD to the same standard as hospital ophthalmologists. The trial employed a novel approach as participation was entirely through a web-based application; the trial required very few resources compared with those that would have been needed for a conventional randomised controlled clinical trial.

Systematics and evolution of coastal and deepwater Hydrozoa from the NE Atlantic

The study of the Portuguese Hydrozoa fauna has been abandoned for more than half a century, except for the Azores archipelago. One of the main aims of this Ph.D. project was to contribute new hydrozoan records leading to a more accurate perception of the actual hydrozoan diversity found in Portuguese waters, including the archipelagos of Azores and Madeira, and neighbouring geographical areas, for habitats ranging from the deep sea to the intertidal. Shallow water hydroids from several Portuguese marine regions (including the Gorringe Bank) were sampled by scuba-diving. Deep-water hydroids, from the Azores, Madeira, Gulf of Cadiz and Alboran Sea, were collected by researchers of different institutions during several oceanographic campaigns. Occasional hydroid sampling by scuba-diving was performed in the UK, Malta and Spain. Over 300 hydroid species were identified and about 600 sequences of the hydrozoan ‘DNA barcode’ 16S mRNA were generated. The families Sertulariidae, Plumulariidae, Lafoeidae, Hebellidae, Aglaopheniidae, Campanulinidae, Halopterididae, Kirchenpaueriidae, Haleciidae and Eudendriidae, were studied in greater detail. About 350 16S sequences were generated for these taxa, allowing phylogenetic, phylogeographic and evolutionary inferences, and also more accurate taxonomic identifications. Phylogenetic analyses integrated molecular and morphological characters. Subsequent results revealed: particularly high levels of cryptic biodiversity, polyphyly in many taxonomic groups, pairs of species that were synonymous, the identity of several varieties as valid species, and highlighted phylogeographic associations of hydroids in deep and shallow-water areas of the NE Atlantic and W Mediterranean. It was proved that many (but not all) marine hydroid species with supposedly widespread vertical and/or horizontal geographical distributions, correspond in fact to complexes of cryptic taxa. This study further revealed that, in the NE Atlantic, shallow environments sustain higher hydrozoan diversity and abundance, but the importance of bathyal habitats as a source of phylogenetic diversity was also revealed. The Azorean seamounts were shown to be particularly important in the segregation of populations of hydroids with reduced dispersive potential. The bathyal habitats of the Gulf of Cadiz proved to harbour a considerably high number of cryptic species, which may mainly be a consequence of habitat heterogeneity and convergence of various water masses in the Gulf. The main causes proposed for speciation and population divergence of hydroids were: species population size, dispersal mechanisms and plasticity to inhabit different environmental conditions, but also the influence of oceanic currents (and its properties), habitat heterogeneity, climate change and continental drift. Higher phylogenetic resolution obtained for the family Plumulariidae revealed particularly that glacial cycles likely facilitated population divergence, ultimately speciation, and also faunal evolutionary transitions from deep to shallow waters.

Development of open models and tools for seismic risk assessment: application to Portugal

The exponential growth of the world population has led to an increase of settlements often located in areas prone to natural disasters, including earthquakes. Consequently, despite the important advances in the field of natural catastrophes modelling and risk mitigation actions, the overall human losses have continued to increase and unprecedented economic losses have been registered. In the research work presented herein, various areas of earthquake engineering and seismology are thoroughly investigated, and a case study application for mainland Portugal is performed. Seismic risk assessment is a critical link in the reduction of casualties and damages due to earthquakes. Recognition of this relation has led to a rapid rise in demand for accurate, reliable and flexible numerical tools and software. In the present work, an open-source platform for seismic hazard and risk assessment is developed. This software is capable of computing the distribution of losses or damage for an earthquake scenario (deterministic event-based) or earthquake losses due to all the possible seismic events that might occur within a region for a given interval of time (probabilistic event-based). This effort has been developed following an open and transparent philosophy and therefore, it is available to any individual or institution. The estimation of the seismic risk depends mainly on three components: seismic hazard, exposure and vulnerability. The latter component assumes special importance, as by intervening with appropriate retrofitting solutions, it may be possible to decrease directly the seismic risk. The employment of analytical methodologies is fundamental in the assessment of structural vulnerability, particularly in regions where post-earthquake building damage might not be available. Several common methodologies are investigated, and conclusions are yielded regarding the method that can provide an optimal balance between accuracy and computational effort. In addition, a simplified approach based on the displacement-based earthquake loss assessment (DBELA) is proposed, which allows for the rapid estimation of fragility curves, considering a wide spectrum of uncertainties. A novel vulnerability model for the reinforced concrete building stock in Portugal is proposed in this work, using statistical information collected from hundreds of real buildings. An analytical approach based on nonlinear time history analysis is adopted and the impact of a set of key parameters investigated, including the damage state criteria and the chosen intensity measure type. A comprehensive review of previous studies that contributed to the understanding of the seismic hazard and risk for Portugal is presented. An existing seismic source model was employed with recently proposed attenuation models to calculate probabilistic seismic hazard throughout the territory. The latter results are combined with information from the 2011 Building Census and the aforementioned vulnerability model to estimate economic loss maps for a return period of 475 years. These losses are disaggregated across the different building typologies and conclusions are yielded regarding the type of construction more vulnerable to seismic activity.

Determinants of online travel purchase intentions: a holistic approach

Online travel shopping has attracted researchers due to its significant growth and there is a growing body of literature in this field. However, research on what drives consumers to purchase travel online has typically been fragmented. In fact, existing studies have largely concentrated on examining consumers’ online travel purchases either grounded on Davis’s Technology Acceptance Model, on the Theory of Reasoned Action and its extension, the Theory of Planned Behaviour or on Roger’s model of perceived innovation attributes, the Innovation Diffusion Theory. A thorough literature review has revealed that there is a lack of studies that integrate all theories to better understand online travel shopping. Therefore, based on relevant literature in tourism and consumer behaviour, this study proposes and tests an integrated model to explore which factors affect intentions to purchase travel online. Furthermore, it proposes a new construct, termed social media involvement, defined as a person’s level of interest or emotional attachment with social media, and examines its relationship with intentions to purchase travel online. To test the 18 hypotheses, a quantitative approach was followed by first collecting data through an online survey. With a sample of 1,532 Worldwide Internet users, Partial Least Squares analysis was than conducted to assess the validity and reliability of the data and empirically test the hypothesized relationships between the constructs. The results indicate that intentions to purchase travel online is mostly determined by attitude towards online shopping, which is influenced by perceived relative advantages of online travel shopping and trust in online travel shopping. In addition, the findings indicate that the second most important predictor of intentions to purchase travel online is compatibility, an attribute from the Innovation Diffusion Theory. Furthermore, even though online shopping is nowadays a common practice, perceived risk continues to negatively affect intentions to purchase travel online. The most surprising finding of this study was that Internet users more involved with social media for travel purposes did not have higher intentions to purchase travel online. The theoretical contributions of this study and the practical implications are discussed and future research directions are detailed.

Effects of Unionization on Graduate Student Employees: Faculty-Student Relations, Academic Freedom, and Pay

In cases involving unionization of graduate student research and teaching assistants at private U.S. universities, the National Labor Relations Board has, at times, denied collective bargaining rights on the presumption that unionization would harm faculty-student relations and academic freedom. Using survey data collected from PhD students in five academic disciplines across eight public U.S. universities, the authors compare represented and non-represented graduate student employees in terms of faculty-student relations, academic freedom, and pay. Unionization does not have the presumed negative effect on student outcomes, and in some cases has a positive effect. Union-represented graduate student employees report higher levels of personal and professional support, unionized graduate student employees fare better on pay, and unionized and nonunionized students report similar perceptions of academic freedom. These findings suggest that potential harm to faculty-student relationships and academic freedom should not continue to serve as bases for the denial of collective bargaining rights to graduate student employees.

Challenges and Opportunities in Healthcare Volunteer Management: Insights from Volunteer Administrators

Volunteer administrators from 105 hospitals in five states in the northeast and southern United States provided open-ended survey responses about what they perceived to be the most pressing challenges and opportunities facing healthcare volunteer management. Taken together, these 105 hospitals used a total of 39,008 volunteers and 5.3 million volunteer hours during a 12-month period between 2010 and 2011. A qualitative content analysis of administrator responses suggests that primary challenges include volunteer recruitment and retention, administrative issues, and operational difficulties brought about by the current economic crisis. Key opportunities include more explicitly linking the volunteer function to hospital outcomes and community impact, expanding volunteer recruitment pools and roles and jobs, and developing organizational support for volunteers and making the volunteer management function more efficient and effective.

Strategic Human Resource Management of Volunteers and the Link to Hospital Patient Satisfaction

This article uses strategic human resource management theory to consider the ways in which volunteers can potentially enhance hospital patient satisfaction. Results of a structural equation modeling analysis of multi-source data on 107 U.S. hospitals show positive associations between hospital strategy, volunteer management practices, volunteer workforce attributes, and patient satisfaction. Although no causality can be assumed, the results shed light on the volunteer–patient satisfaction relationship and have important implications for hospital leaders, volunteer administrators, and future research.

Choosing Union Representation: The Role of Attitudes and Emotions

In the United States, most unions are recognized by a majority vote of employees through union representation elections administered by the government. Most empirical studies of individual voting behavior during union representation elections use a rational choice model. Recently, however, some have posited that voting is often influenced by emotions. We evaluate competing hypotheses about the determinants of union voting behavior by using data collected from a 2010 representation election at Delta Air Lines, a US-based company. In addition to the older rational choice framework, multiple regression results provide support for an emotional choice model. Positive feelings toward the employer are statistically significantly related to voting ‘no’ in a representation election, while positive feelings toward the union are related to a ‘yes’ vote. Effect sizes for the emotion variables were generally larger than those for the rational choice variables, suggesting that emotions may play a key role in representation election outcomes.

A herança de Locke

A organização de um colóquio em torno da “herança de Locke” foi uma ideia que nasceu no Centro de Estudos Anglísticos da Universidade de Lisboa, no âmbito do núcleo de investigação dedicado aos estudos de cultura inglesa. Vários textos de Locke são regularmente incluídos nos programas de graduação e de pósgraduação em Estudos Anglísticos, além de objecto de estudo especializado no Centro de Estudos Anglísticos. Assim, fazia todo o sentido comemorar, no ano de 2004, a passagem de mais um centenário sobre a morte de Locke, e celebrar a vitalidade da sua obra ao longo de três séculos reunindo especialistas que, publicamente, apresentassem e discutissem aspectos dessa obra que continuam activos no presente. O volume que agora se publica reúne as comunicações apresentadas em Janeiro de 2004. A variedade dos temas abordados e a manifesta relevância de que se revestem para o estudo da modernidade demonstram que a herança de Locke continua a produzir riqueza, e que constitui património cultural a ser herdado por novas gerações.

O homem novo do fascismo italiano e do estado novo português

Tese de doutoramento, História (Dinâmicas do Mundo Contemporâneo), Universidade de Lisboa, ISCTE - Instituto Universitário de Lisboa, Universidade Católica Portuguesa, Universidade de Évora, 2014

Arabidopsis T-DNA Insertional Lines For CDC25 Are Hypersensitive to Hydroxyurea But Not to Zeocin or Salt Stress.

Background and Aims In yeasts and animals, cyclin-dependent kinases are key regulators of cell cycle progression and are negatively and positively regulated by WEE1 kinase and CDC25 phosphatase, respectively. In higher plants a full-length orthologue of CDC25 has not been isolated but a shorter gene with homology only to the C-terminal catalytic domain is present. The Arabidopis thaliana;CDC25 can act as a phosphatase in vitro. Since in arabidopsis, WEE1 plays an important role in the DNA damage/DNA replication checkpoints, the role of Arath;CDC25 in conditions that induce these checkpoints or induce abiotic stress was tested. Methods arath;cdc25 T-DNA insertion lines, Arath;CDC25 over-expressing lines and wild type were challenged with hydroxyurea (HU) and zeocin, substances that stall DNA replication and damage DNA, respectively, together with an abiotic stressor, NaCl. A molecular and phenotypic assessment was made of all genotypes Key Results There was a null phenotypic response to perturbation of Arath;CDC25 expression under control conditions. However, compared with wild type, the arath;cdc25 T-DNA insertion lines were hypersensitive to HU, whereas the Arath;CDC25 over-expressing lines were relatively insensitive. In particular, the over-expressing lines consistently outgrew the T-DNA insertion lines and wild type when challenged with HU. All genotypes were equally sensitive to zeocin and NaCl. Conclusions Arath;CDC25 plays a role in overcoming stress imposed by HU, an agent know to induce the DNA replication checkpoint in arabidopsis. However, it could not enhance tolerance to either a zeocin treatment, known to induce DNA damage, or salinity stress.

Gene Dosage Effect of WEE1 on Growth and Morphogenesis from Arabidopsis Hypocotyl Explants.

Background and Aims How plant cell-cycle genes interface with development is unclear. Preliminary evidence from our laboratory suggested that over-expression of the cell cycle checkpoint gene, WEE1, repressed growth and development. Here the hypothesis is tested that the level of WEE1 has a dosage effect on growth and development in Arabidospis thaliana. To do this, a comparison was made of the development of gain- and loss-of-function WEE1 arabidopsis lines both in vivo and in vitro. Methods Hypocotyl explants from an over-expressing Arath;WEE1 line (WEE1oe), two T-DNA insertion lines (wee1-1 and wee1-4) and wild type (WT) were cultured on two-way combinations of kinetin and naphthyl acetic acid. Root growth and meristematic cell size were also examined. Key Results Quantitative data indicated a repressive effect in WEE1oe and a significant increase in morphogenetic capacity in the two T-DNA insertion lines compared with WT. Compared with WT, WEE1oe seedlings exhibited a slower cell-doubling time in the root apical meristem and a shortened primary root, with fewer laterals, whereas there were no consistent differences in the insertion lines compared with WT. However, significantly fewer adventitious roots were recorded for WEE1oe and significantly more for the insertion mutant wee1-1. Compared with WT there was a significant increase in meristem cell size in WEE1oe for all three ground tissues but for wee1-1 only cortical cell size was reduced. Conclusions There is a gene dosage effect of WEE1 on morphogenesis from hypocotyls both in vitro and in vivo.

Perturbation of Cytokinin and Ethylene-signalling Pathways Explain the Strong Rooting Phenotype Exhibited by Arabidopsis Expressing the Schizosaccharomyces Pombe mitotic inducer, cdc25.

Background Entry into mitosis is regulated by cyclin dependent kinases that in turn are phosphoregulated. In most eukaryotes, phosphoregulation is through WEE1 kinase and CDC25 phosphatase. In higher plants a homologous CDC25 gene is unconfirmed and hence the mitotic inducer Schizosaccharomyces pombe (Sp) cdc25 has been used as a tool in transgenic plants to probe cell cycle function. Expression of Spcdc25 in tobacco BY-2 cells accelerates entry into mitosis and depletes cytokinins; in whole plants it stimulates lateral root production. Here we show, for the first time, that alterations to cytokinin and ethylene signaling explain the rooting phenotype elicited by Spcdc25 expression in Arabidopsis. Results Expressing Spcdc25 in Arabidopsis results in increased formation of lateral and adventitious roots, a reduction of primary root width and more isodiametric cells in the root apical meristem (RAM) compared with wild type. Furthermore it stimulates root morphogenesis from hypocotyls when cultured on two way grids of increasing auxin and cytokinin concentrations. Microarray analysis of seedling roots expressing Spcdc25 reveals that expression of 167 genes is changed by > 2-fold. As well as genes related to stress responses and defence, these include 19 genes related to transcriptional regulation and signaling. Amongst these was the up-regulation of genes associated with ethylene synthesis and signaling. Seedlings expressing Spcdc25 produced 2-fold more ethylene than WT and exhibited a significant reduction in hypocotyl length both in darkness or when exposed to 10 ppm ethylene. Furthermore in Spcdc25 expressing plants, the cytokinin receptor AHK3 was down-regulated, and endogenous levels of iPA were reduced whereas endogeous IAA concentrations in the roots increased. Conclusions We suggest that the reduction in root width and change to a more isodiametric cell phenotype in the RAM in Spcdc25 expressing plants is a response to ethylene over-production. The increased rooting phenotype in Spcdc25 expressing plants is due to an increase in the ratio of endogenous auxin to cytokinin that is known to stimulate an increased rate of lateral root production. Overall, our data reveal important cross talk between cell division and plant growth regulators leading to developmental changes.

A Student Composers' Recital, May 7, 1959 8:30pm

Concert program for A Student Composers' Recital, May 7, 1959