Women’s Wellness after Cancer Program Study (WWACP)– A multi centre randomised controlled trial examining the benefits and cost effectiveness of an Evidenced Based, e-health intervention

Background Advances in cancer diagnosis and treatment have significantly improved survival rates, through their subsequent health needs are often not adequately addressed by current health services. National Health and Medical Research Council (NHMRC) Partnerships Project awarded a national collaborative project to develop, trial and evaluate clinical benefits and cost effectiveness of an e-health enabled structured health promotion intervention - The Women’s Wellness after Cancer Program (WWACP). The aim of this e-health enabled multimodal intervention is to improve health related quality of life in women previously treated for target cancers. Aim The WWACP is a 12-week web based, interactive, holistic program. Primary outcomes for this project are to promote a positive change in health-related quality of life (HRQoL) and reduction in Body Mass Index (BMI) in the women undertaking WWACP compared to women who receive usual care. Secondary outcomes include managing other side effects of cancer treatment through evidence-based nutrition and exercise practices, dealing with stress, sleep, menopause and sexuality issues. Methods The single-blinded multi-center randomized controlled trial recruited a toatl of 330 women within 24 months of completion of chemotherapy and /or radiotherapy. Women were randomly assigned to either a usual care or intervention group. Women provided with the intervention were provided with an interactive iBook and journal, web interface, and three virtual consultations by experienced cancer nurses. A variety of methods were utilized, to enable positive self- efficacy and lifestyle changes. These include online coaching with a registered nurse trained in the intervention, plus written educational and health promotional information. The program has been delivered through the e-health enabled interfaces, which enables virtual delivery via desktop and mobile computing devices. Importantly this enables accessibility for rural and regional women in Australia who are frequently geographically disadvantaged in terms of health care provision. Results Research focusing on alternative methods of delivering post treatment / or survivorship care in cancer utilizing web based interfaces is limited, but emerging evidence suggests that Internet interventions can increase psychological and physical wellbeing in cancer patients. The WWACP trial aims to establish the effectiveness of delivery of the program in terms of positive patient outcomes and cost effective, flexibility. The trial will be completed in September and results will be presented at the conference. Conclusions Women after acute hematological, breast and gynecological cancer treatments demonstrate good cancer survival rates and face residual health problems which are amenable to behavioral interventions. The conclusion of active treatment is a key 'teachable moment' in which sustainable positive lifestyle change can be achieved if patients receive education and psychological support which targets key treatment related health problems and known chronic disease risk factors.

Nationalism Circumscribed : Transnational Governance of Minority Rights in Post-Cold War Europe

For the past two centuries, nationalism has been among the most influential legitimizing principles of political organization. According to its simple definition, nationalism is a principle or a way of thinking and acting which holds that the world is divided into nations, and that national and political units should be congruent. Nationalism can thus be divided into two aspects: internal and external. Internally, the political units, i.e., states, should be made up of only one nation. Externally each nation-state should be sovereign. Transnational national governance of rights of national minorities violates both these principles. This study explores the formation, operation, and effectiveness of the European post-Cold War minorities system. The study identifies two basic approaches to minority rights: security and justice. These approaches have been used to legitimize international minority politics and they also inform the practice of transnational governance. The security approach is based on the recognition that the norm of national self-determination cannot be fulfilled in all relevant cases, and so minority rights are offered as a compensation to the dissatisfied national groups, reducing their aspiration to challenge the status quo. From the justice perspective, minority rights are justified as a compensatory strategy against discrimination caused by majority nation-building. The research concludes that the post-Cold War minorities system was justified on the basis of a particular version of the security approach, according to which only Eastern European minority situations are threatening because of the ethnic variant of nationalism that exists in that region. This security frame was essential in internationalising minority issues and justifying the swift development of norms and institutions to deal with these issues. However, from the justice perspective this approach is problematic, since it justified double standards in European minority politics. Even though majority nation-building is often detrimental to minorities also in Western Europe, Western countries can treat their minorities more or less however they choose. One of the main contributions of this thesis is the detailed investigation of the operation of the post-Cold War minorities system. For the first decade since its creation in the early 1990s, the system operated mainly through its security track, which is based on the field activities of the OSCE that are supported by the EU. The study shows how the effectiveness of this track was based on inter-organizational cooperation in which various transnational actors compensate for each other s weaknesses. After the enlargement of the EU and dissolution of the membership conditionality this track, which was limited to Eastern Europe from the start, has become increasingly ineffective. Since the EU enlargement, the focus minorities system has shifted more and more towards its legal track, which is based on the Framework Convention for the Protection of National Minorities (Council of Europe). The study presents in detail how a network of like-minded representatives of governments, international organizations, and independent experts was able strengthen the framework convention s (originally weak) monitoring system considerably. The development of the legal track allows for a more universal and consistent, justice-based approach to minority rights in contemporary Europe, but the nationalist principle of organization still severely hinders the materialization of this possibility.

Harmful algal research and response: A human dimensions strategy

Harmful Algal Research and Response: A Human Dimensions Strategy (HARR-HD) justifies and guides a coordinated national commitment to human dimensions research critical to prevent and respond to impacts of harmful algal blooms (HABs). Beyond HABs, it serves as a framework for developing hu-man dimensions research as a cross-cutting priority of ecosystem science supporting coastal and ocean management, including hazard research and mitigation planning. Measuring and promoting commu-nity resilience to hazards require human dimensions research outcomes such as effective risk commu-nication strategies; assessment of community vulnerability; identification of susceptible populations; comprehensive assessment of environmental, sociocultural, and economic impacts; development of effective decision support tools; and improved coordination among agencies and stakeholders. HARR-HD charts a course for human dimensions research to achieve these and other priorities through co-ordinated implementation by the Joint Subcommittee on Ocean Science and Technology (JSOST) In-teragency Working Group on HABs, Hypoxia and Human Health (IWG-4H); national HAB funding programs; national research and response programs; and state research and monitoring programs. (PDF contains 72 pages)

Ensino e aprendizado em serviços de atenção básica do SUS: desafios da formação médica com a perspectiva da integralidade narrativas e tessituras

Esta investigação enfoca processos de ensino, aprendizagem e avaliação na graduação médica, que acontecem em serviços básicos do Sistema Único de Saúde (SUS), com ênfase nos entraves e potencialidades para a transformação das relações entre a formação e a assistência na perspectiva da integralidade, tendo como referência as Diretrizes Curriculares Nacionais para os Cursos de Graduação em medicina, homologadas pelo Conselho Nacional de Educação em 2001. Com uma abordagem metodológica qualitativa que reúne contribuições da etnografia, da pesquisa transdisciplinar e da cartografia, a pesquisadora propõe ao leitor um diálogo com os relatos de suas observações (de experiências formativas na atenção básica) e dados oriundos da sua própria preceptoria de estudantes de medicina envolvidos em atividades em um centro municipal de saúde. Aponta desafios que necessitam ser enfrentados como: a hegemonia da racionalidade biomédica na conformação do modelo tecnoassistencial e a necessidade de efetivar uma política de recursos humanos no setor que incentive a integração universidade-serviço-comunidade, na aproximação da graduação ao cotidiano do trabalho em saúde e à realidade de vida da população. Estas questões estão associadas ao atual debate sobre integração curricular , educação permanente visando uma práxis formativa criativa que envolva o desenvolvimento de competências (técnico-políticas) e o compromisso para com o cuidado no SUS. Conclui que é justamente na trama local cotidiana, na problematização e intercâmbio entre experiências, que afloram caminhos criativos na superação das rotinas e práticas mecanizadas . Estes processos transformadores são matérias de reflexão para que novos projetos de cuidado sejam construídos coletivamente, emergindo novos patamares na assistência e na formação.

As repercussões corporais vivenciadas pela mulher com câncer de mama decorrentes do tratamento quimioterápico: uma análise à luz da Teoria de Sister Callista Roy

O câncer de mama constitui-se no câncer mais frequente na população feminina mundial e brasileira. A quimioterapia antineoplásica encontra-se entre as formas de tratamento mais temidas pela mulher à medida que experimenta efeitos colaterais agressivos. O estudo tem como objetivos: identificar as repercussões corporais decorrentes do tratamento quimioterápico que são reconhecidas pelas mulheres; descrever os mecanismos de enfrentamento que a mulher com câncer de mama utiliza para lidar com essas repercussões; Analisar as repercussões corporais vivenciadas pelas mulheres com câncer de mama à luz da Teoria de Sister Callista Roy; apontar as ações de enfermagem reconhecidas pelas mulheres com câncer de mama relacionadas com a vivência das repercussões corporais. Trata-se de uma pesquisa de campo, de abordagem qualitativa. O estudo teve como cenário a Seção de Oncologia do Hospital Universitário Pedro Ernesto. Os sujeitos da pesquisa foram mulheres com câncer de mama com idade superior a 18 anos em tratamento na instituição. Foram observados os princípios da Resolução 196/96 do Conselho Nacional de Saúde. A coleta de dados se deu através de entrevista individual do tipo semiestruturada. O processamento e análise dos dados foram compostos pela transcrição e leitura das entrevistas, e alvo de reflexão à luz do referencial de análise de conteúdo de Bardin e Modelo Adaptativo de Roy. Foram identificadas as seguintes categorias: 1) alterações corporais decorrentes da doença e o tratamento, com as subcategorias: compreensão da mulher acerca da doença e tratamento, Sentimentos relacionados ao diagnóstico de câncer e os efeitos colaterais do tratamento; 2) enfrentando o câncer de mama e seu tratamento; 3) a meta da enfermagem: promoção da adaptação da mulher com câncer de mama. Os resultados demonstraram uma relação próxima entre os achados e a Teoria de Sister Callista Roy.

Vivenciando a amamentação e sensações de prazer sexual e/ou excitação sexual ao amamentar: significados de mulheres

Trata-se de uma pesquisa com abordagem qualitativa e descritiva, com a utilização da Grounded Theory, na perspectiva do Interacionismo Simbólico. Como objetivos tivemos: identificar os significados atribuídos por mulheres ao fato de experimentar, sentir ou vivenciar sensações de prazer sexual e/ou excitação sexual durante a amamentação; analisar e interpretar, na perspectiva do Interacionismo Simbólico, a experiência de sentir prazer sexual e/ou excitação sexual durante a amamentação, a partir dos significados atribuídos pelas mulheres. O estudo procedeu-se no Município do Rio de Janeiro, em lugares de grande circulação de pessoas, como praças, ruas, shoppings, além da Unidade de Saúde Milton Fontes Magarão, localizada na zona norte do referido Município. Essa variedade de cenários nos possibilitou encontrar uma diversidade de participantes, referente a condições socioeconômicas, culturais, religião, ideais e concepções sobre o assunto estudado. A coleta e análise dos dados aconteceram no período de maio a julho de 2014, observando todas as exigências da Resolução 466/2012 do Conselho Nacional de Saúde. Foram entrevistadas 17 participantes e formados dois grupos amostrais e três categorias expressas por: significando a amamentação como ato sagrado, inocente e assexuado: a socialização da amamentação; vivenciando e significando sensações de prazer ao amamentar; ressignificando a vivência de sensações de excitação sexual ao amamentar. Como resultados evidenciou-se que a socialização da amamentação influencia a maioria das mulheres, na vivência de sensações de prazer ao amamentar. Essas sensações são descritas através da simbologia estabelecida socialmente, de que o ato de amamentar é sagrado, puro, livre de erotismo, prevalecendo um prazer maternal. Além disso, as sensações de excitação sexual ao amamentar, para as mulheres que se dizem nunca terem vivenciado, estão presentes no seu inconsciente, porém essa vivência é admitida para os outros e não para si mesmas. O significado de vivenciar prazer sexual ao amamentar é percebido como contraditório, pois ao mesmo tempo em que se identifica o poder do corpo feminino, prevalece o poder de nutrir sobre as percepções físicas de excitação sexual ao amamentar. Desse modo, identificaram-se estratégias utilizadas para bloquear ou para não vivenciar as sensações de excitação sexual ao amamentar. Com isso, este estudo nos mostra como as mulheres agem frente às sensações de prazer sexual e/ou excitação sexual ao amamentar, através da interação social do passado e do presente, gerando os significados que cada uma carrega consigo. Além disso, percebemos como a socialização da amamentação priva a vivência da sexualidade feminina, nos aspectos de sensações de prazer sexual durante a amamentação.

Assessment of cattle genetic introgression into domestic yak populations using mitochondrial and microsatellite DNA markers

Hybridization between yak Poephagus grunniens and taurine Bos taurus or indicine B. indicus cattle has been widely practiced throughout the yak geographical range, and gene flow is expected to have occurred between these species. To assess the impact of cattle admixture on domestic yak, we examined 1076 domestic yak from 29 populations collected in China, Bhutan, Nepal, India, Pakistan, Kyrgyzstan, Mongolia and Russia using mitochondrial DNA and 17 autosomal microsatellite loci. A cattle diagnostic marker-based analysis reveals cattle-specific mtDNA and/or autosomal microsatellite allele introgression in 127 yak individuals from 22 populations. The mean level of cattle admixture across the populations, calculated using allelic information at 17 autosomal microsatellite loci, remains relatively low (mY(cattle) = 2.66 +/- 0.53% and Q(cattle) = 0.69 +/- 2.58%), although it varies a lot across populations as well as among individuals within population. Although the level of cattle admixture shows a clear geographical structure, with higher levels of admixture in the Qinghai-Tibetan Plateau and Mongolian and Russian regions, and lower levels in the Himalayan and Pamir Plateau region, our results indicate that the level of cattle admixture is not significantly correlated with the altitude across geographical regions as well as within geographical region. Although yak-cattle hybridization is primarily driven to produce F-1 hybrids, our results show that the subsequent gene flow between yak and cattle took place and has affected contemporary genetic make-up of domestic yak. To protect yak genetic integrity, hybridization between yak and cattle should be tightly controlled.

A single amino acid defines cross-species reactivity of tree shrew (Tupaia belangeri) CD1d to human invariant natural killer T (iNKT) cells

P>The non-classical major histocompatibility complex (MHC) class I molecule CD1d presents lipid antigens to invariant natural killer T (iNKT) cells, which are an important part of the innate immune system. CD1d/iNKT systems are highly conserved in evoluti

Effects of Prenatal Exposure to a 50-Hz Magnetic Field on One-Trial Passive Avoidance Learning in 1-Day-Old Chicks

We investigated memory impairment in newly hatched chicks following in ovo exposure to a 50-Hz magnetic field (MF) of 2 mT (60 min/day) on embryonic days 12-18. Isolated and paired chicks were used to test the effect of stress during training, and memory retention was tested at 10, 30, and 120 min, following exposure to a bitter-tasting bead (100% methylanthranilate). Results showed that memory was intact at 10 min in both isolated and paired chicks with or without MF exposure. However, while isolated chicks had good memory retention levels at 30 and 120 min, those exposed to MF did not. The results suggest a potential disruption of memory formation following in ovo exposure to MF, with this effect only evident in the more stressed, isolated chicks. Bioelectromagnetics 31:150-155, 2010. (C) 2009 Wiley-Liss. Inc.

KHAWIA SAUROGOBII N. SP (CESTODA: CARYOPHYLLIDEA) FROM FRESHWATER FISH SAUROGOBIO SPP. (CYPRINIDAE) IN CHINA

Khawia saurogobii n. sp. is described from the intestine of the cyprinid fishes Saurogobio dabryi and Saurogobio dumerili in China. The new species belongs to the Lytocestidae and is placed in Khawia because of its afossate scolex, vitelline follicles in the cortical parenchyma, uterus not looping anterior to the cirrus sac, gonopores separate but close together in distinct genital atrium, external seminal vesicle absent, and postovarian follicles present. The new species differs from other congeneric species by the shape of the body markedly tapering posteriorly from the end of the anterior third, the shape of the scolex that is very short and markedly wider than the neck, spatulate without incisions, but shallow superficial grooves, vitelline follicles and testes starting immediately posterior to the scolex, and an ovary with long, posterior arms bent medially, thus giving the shape of an inverted A.

Nature of interfacial defects and their roles in strain relaxation at highly lattice mismatched 3C-SiC/Si (001) interface

Misfit defects in a 3C-SiC/Si (001) interface were investigated using a 200 kV high-resolution electron microscope with a point resolution of 0.194 nm. The [110] high-resolution electron microscopic images that do not directly reflect the crystal structure were transformed into the structure map through image deconvolution. Based on this analysis, four types of misfit dislocations at the 3C-SiC/Si (001) interface were determined. In turn, the strain relaxation mechanism was clarified through the generation of grow-in perfect misfit dislocations (including 90 degrees Lomer dislocations and 60 degrees shuffle dislocations) and 90 partial dislocations associated with stacking faults. (C) 2009 American Institute of Physics. [doi:10.1063/1.3234380]

Hyperfine quenching of the 3s3p P-3(0) level in Mg-like ions

Hyperfine quenching rates of the 3s3p P-3(0) level in Mg-like ions were calculated using the GRASP2K package based on the multi-configuration Dirac-Hartree-Fock method. Valence and core-valence correlation effects were accounted for in a systematic way. Breit interactions and QED effects were included in the subsequent relativistic CI calculations. Calculated rates were compared with other theoretical values and with experiment, and a good agreement with the latest experimental value for the Al-27(+) ion (Rosenband et al 2007 Phys. Rev. Lett. 98 220801) was found. Furthermore, we showed in detail the contributions from Breit interaction and QED effects to concerned physical properties. Finally, electronic data were presented in terms of a general scaling law in Z that, given isotopic nuclear spin and magnetic moment, allows hyperfine-induced decay rates to be estimated for any isotope along the isoelectronic sequence.

A data-model fusion approach for upscaling gross ecosystem productivity to the landscape scale based on remote sensing and flux footprint modelling

Chinese Academy of Sciences ; National Science Foundation of China [41071059]; National Key Technology R&D Program of China [2008BAK50B06-02]; National Basic Research Program of China [2010CB950900, 2010CB950704]; Natural Sciences and Engineering Research Council of Canada

Validating MODIS-derived land surface evapotranspiration with in situ measurements at two AmeriFlux sites in a semiarid region

Reducing uncertainties in the estimation of land surface evapotranspiration (ET) from remote-sensing data is essential to better understand earth-atmosphere interactions. This paper demonstrates the applicability of temperature-vegetation index triangle (T-s-VI) method in estimating regional ET and evaporative fraction (EF, defined as the ratio of latent heat flux to surface available energy) from MODIS/Terra and MODIS/Aqua products in a semiarid region. We have compared the satellite-based estimates of ET and EF with eddy covariance measurements made over 4 years at two semiarid grassland sites: Audubon Ranch (AR) and Kendall Grassland (KG). The lack of closure in the eddy covariance measured surface energy components is shown to be more serious at MODIS/Aqua overpass time than that at MODIS/Terra overpass time for both AR and KG sites. The T-s-VI-derived EF could reproduce in situ EF reasonably well with BIAS and root-mean-square difference (RMSD) of less than 0.07 and 0.13, respectively. Surface net radiation has been shown to be systematically overestimated by as large as about 60 W/m(2). Satisfactory validation results of the T-s-VI-derived sensible and latent heat fluxes have been obtained with RMSD within 54 W/m(2). The simplicity and yet easy use of the T-s-VI triangle method show a great potential in estimating regional ET with highly acceptable accuracy that is of critical significance in better understanding water and energy budgets on the Earth. Nevertheless, more validation work should be carried out over various climatic regions and under other different land use/land cover conditions in the future.

Depolarization of sperm membrane potential is a common feature of men with subfertility and is associated with low fertilization rate at IVF

STUDY QUESTION. Are significant abnormalities in outward (K+) conductance and resting membrane potential (Vm) present in the spermatozoa of patients undertaking IVF and ICSI and if so, what is their functional effect on fertilization success? SUMMARY ANSWER. Negligible outward conductance (≈5% of patients) or an enhanced inward conductance (≈4% of patients), both of which caused depolarization of Vm, were associated with a low rate of fertilization following IVF. WHAT IS KNOWN ALREADY. Sperm-specific potassium channel knockout mice are infertile with defects in sperm function, suggesting that these channels are essential for fertility. These observations suggest that malfunction of K+ channels in human spermatozoa might contribute significantly to the occurrence of subfertility in men. However, remarkably little is known of the nature of K+ channels in human spermatozoa or the incidence and functional consequences of K+ channel defects. STUDY DESIGN, SIZE AND DURATION. Spermatozoa were obtained from healthy volunteer research donors and subfertile IVF and ICSI patients attending a hospital assisted reproductive techniques clinic between May 2013 and December 2015. In total, 40 IVF patients, 41 ICSI patients and 26 normozoospermic donors took part in the study. PARTICIPANTS/MATERIALS, SETTING, METHODS. Samples were examined using electrophysiology (whole-cell patch clamping). Where abnormal electrophysiological characteristics were identified, spermatozoa were further examined for Ca2+ influx induced by progesterone and penetration into viscous media if sufficient sample was available. Full exome sequencing was performed to specifically evaluate potassium calcium-activated channel subfamily M α 1 (KCNMA1), potassium calcium-activated channel subfamily U member 1 (KCNU1) and leucine-rich repeat containing 52 (LRRC52) genes and others associated with K+ signalling. In IVF patients, comparison with fertilization rates was done to assess the functional significance of the electrophysiological abnormalities. MAIN RESULTS AND THE ROLE OF CHANCE. Patch clamp electrophysiology was used to assess outward (K+) conductance and resting membrane potential (Vm) and signalling/motility assays were used to assess functional characteristics of sperm from IVF and ICSI patient samples. The mean Vm and outward membrane conductance in sperm from IVF and ICSI patients were not significantly different from those of control (donor) sperm prepared under the same conditions, but variation between individuals was significantly greater (P< 0.02) with a large number of outliers (>25%). In particular, in ≈10% of patients (7/81), we observed either a negligible outward conductance (4 patients) or an enhanced inward current (3 patients), both of which caused depolarization of Vm. Analysis of clinical data from the IVF patients showed significant association of depolarized Vm (≥0 mV) with low fertilization rate (P= 0.012). Spermatozoa with electrophysiological abnormities (conductance and Vm) responded normally to progesterone with elevation of [Ca2+]i and penetration of viscous medium, indicating retention of cation channel of sperm (CatSper) channel function. LIMITATIONS, REASONS FOR CAUTION. For practical, technical, ethical and logistical reasons, we could not obtain sufficient additional semen samples from men with conductance abnormalities to establish the cause of the conductance defects. Full exome sequencing was only available in two men with conductance defects. WIDER IMPLICATIONS OF THE FINDINGS. These data add significantly to the understanding of the role of ion channels in human sperm function and its impact on male fertility. Impaired potassium channel conductance (Gm) and/or Vm regulation is both common and complex in human spermatozoa and importantly is associated with impaired fertilization capacity when the Vm of cells is completely depolarized.