Psychological and social profile of family caregivers upon commencement of palliative care provision

Context
Palliative care services are required to support patients who have advanced, life-threatening, noncurable disease, and their family caregivers. Comprehensive psychological and social support for bereaved family members also is expected. However, recent systematic reviews have demonstrated significant gaps in evidence-based approaches for such support. Furthermore, a comprehensive understanding of the psychological and social response to the family caregiver role is required for support to be optimized.

Objectives
We sought to examine the psychological and social profile of family caregivers on commencement of receiving palliative care services.

Methods
A self-report questionnaire was administered to primary family caregivers of patients within two weeks of admission to three palliative care services in Melbourne, Australia. The questionnaire incorporated six instruments that measured 11 family caregiver-related psychosocial factors; four instruments that measured caregiver psychological distress factors; 14 mental health lifetime risk factors; and a sociodemographic questionnaire.

Results
Three hundred and two family caregivers participated. Nearly half (44%) of the caregivers had a probable anxiety and/or depressive disorder, with 40% scoring more than the cutoff score for probable anxiety and 20% scoring more than the cutoff score for probable depression. Additionally, approximately 15% of caregivers met the criteria for pre-loss grief, and around 10% reported moderate to severe levels of demoralization. Caregivers who had a probable anxiety and/or depressive disorder also reported higher levels of pre-loss grief.

Conclusion
This study provides further evidence of the prevalence of poor psychosocial well-being in this population. The results reinforce the need to develop suitable strategies for psychological and social support for family caregivers.

Three-dimensional pattern formation, multiple homogeneous soft modes, and nonlinear dielectric electroconvection

Patterns forming spontaneously in extended, three-dimensional, dissipative systems are likely to excite several homogeneous soft modes (approximate to hydrodynamic modes) of the underlying physical system, much more than quasi-one- (1D) and two-dimensional (2D) patterns are. The reason is the lack of damping boundaries. This paper compares two analytic techniques to derive the pattern dynamics from hydrodynamics, which are usually equivalent but lead to different results when applied to multiple homogeneous soft modes. Dielectric electroconvection in nematic liquid crystals is introduced as a model for 3D pattern formation. The 3D pattern dynamics including soft modes are derived. For slabs of large but finite thickness the description is reduced further to a 2D one. It is argued that the range of validity of 2D descriptions is limited to a very small region above threshold. The transition from 2D to 3D pattern dynamics is discussed. Experimentally testable predictions for the stable range of ideal patterns and the electric Nusselt numbers are made. For most results analytic approximations in terms of material parameters are given. [S1063-651X(00)09512-X].

Pattern formation of chevrons in the conduction regime in homeotropically aligned liquid crystals

We report on chevrons (herringbonelike patterns) observed in homeotropically aligned liquid crystals with high electric conductivity. We focus our attention on two types of chevrons observed in the conduction regime. The threshold voltage and the characteristic double periodicity of chevrons (i.e., the short wavelength lambda(1) of the striated rolls and the long wavelength lambda(2) Of the chevron bands) have been measured as functions of the applied electric frequency f. With the aid of a crossed polarizer set, we have, in addition, determined the director field which shows a periodic in-plane rotation for our chevrons (with a wavelength lambda(2)) We arrived at the types of chevrons after qualitatively different bifurcation sequences with increasing voltage. The frequency dependence of lambda(2) also shows a qualitatively different behavior with respect to the two types of chevrons. The experimental results are discussed in terms of recent theoretical investigations.

Quantification of all-ceramic crown margin surface profile from try-in to 1-week post-cementation

To use profilometry to assess the margin surface profile of all-ceramic crowns (ACC’s) at try-in and 1-week after cementation with dual-cured resin (DC, RelyX ARC, 3 M ESPE, St. Paul, MN, USA), self-adhesive dual-cured resin (SADC, RelyX Unicem, 3 M ESPE), light-cured resin (LC, RelyX Veneer, 3 M ESPE) or chemically cured resin-modified glass ionomer (RMGI, RelyX Luting Plus, 3 M ESPE) luting cement. Methods: Forty, sound, extracted, human, premolar teeth underwent a standardised preparation for ACC’s. IPS Empress (Ivoclar-Vivadent, Liechtenstein) crowns of standard dimensions were fabricated and 10 luted with each cement and stored in water for 7 days. Three groups of serial profiles were taken, the first of the tooth preparation, the second of the crown margins at try-in and lastly of the crown margins after cementation and 7 days water storage. Results: There were no significant differences in the crown margin surface profile between the four cement groups at try-in. The change in crown margin position between try-in and post-cementation was significantly greater for DC than for LC and RMGI. SADC was not significantly different to the other cements. There were no significant differences in the crown margin extensions between the four cement groups, however most of the IPS Empress ACC’s in this study were underextended but this was not statistically significant. Conclusions: IPS Empress ACC’s seated more fully with LC and RMGI than with DC cement

Modulated electrostatic modes in pair plasmas: Modulational stability profile and envelope excitations

A pair plasma consisting of two types of ions, possessing equal masses and opposite charges, is considered. The nonlinear propagation of modulated electrostatic wave packets is studied by employing a two-fluid plasma model. Considering propagation parallel to the external magnetic field, two distinct electrostatic modes are obtained, namely a quasiacoustic lower moddfe and a Langmuir-like, as optic-type upper one, in agreement with experimental observations and theoretical predictions. Considering small yet weakly nonlinear deviations from equilibrium, and adopting a multiple-scale technique, the basic set of model equations is reduced to a nonlinear Schrodinger equation for the slowly varying electric field perturbation amplitude. The analysis reveals that the lower (acoustic) mode is stable and may propagate in the form of a dark-type envelope soliton (a void) modulating a carrier wave packet, while the upper linear mode is intrinsically unstable, and may favor the formation of bright-type envelope soliton (pulse) modulated wave packets. These results are relevant to recent observations of electrostatic waves in pair-ion (fullerene) plasmas, and also with respect to electron-positron plasma emission in pulsar magnetospheres. (c) 2006 American Institute of Physics.

Analysis of HSC activity and compensatory Hox gene expression profile in Hoxb cluster mutant fetal liver cells

Overexpression of Hoxb4 in bone marrow cells promotes expansion of hematopoietic stem cell (HSC) populations in vivo and in vitro, indicating that this homeoprotein can activate the genetic program that determines self-renewal. However, this function cannot be solely attributed to Hoxb4 because Hoxb4(-/-) mice are viable and have an apparently normal HSC number. Quantitative polymerase chain reaction analysis showed that Hoxb4(-/-) c-Kit(+) fetal liver cells expressed moderately higher levels of several Hoxb cluster genes than control cells, raising the possibility that normal HSC activity in Hoxb4(-/-) mice is due to a compensatory up-regulation of other Hoxb genes. In this study, we investigated the competitive repopulation potential of HSCs lacking Hoxb4 alone, or in conjunction with 8 other Hoxb genes. Our results show that Hoxb4(-/-) and Hoxb1-b9(-/-) fetal liver cells retain full competitive repopulation potential and the ability to regenerate all myeloid and lymphoid lineages. Quantitative Hox gene expression profiling in purified c-KIt(+) Hoxb1-bg(-/-) fetal liver cells revealed an interaction between the Hoxa, b, and c clusters with variation in expression levels of Hoxa4, -a11, and -c4. Together, these studies show a complex network of genetic interactions between several Hox genes in primitive hematopoietic cells and demonstrate that HSCs lacking up to 30% of the active Hox genes remain fully competent.

Short-term phytoestrogen supplementation alters insulin-like growth factor profile but not lipid or antioxidant status

Phytoestrogens are plant compounds that have been proposed to have a variety of health benefits. The aim of this study was to assess the effects of these compounds on a number of physiological endpoints. Subjects were given a single intake of a phytoestrogen-rich (80 mg total phytoestrogens) supplement containing soy, rye and linseed (Phase 1), followed by a week-long intervention using the same supplement (Phase 2) (80 mg total phytoestrogens daily). A number of biochemical endpoints were assessed including urinary phytoestrogen metabolites, lipids, antioxidant status, DNA damage and insulin-like growth factor-1 (IGF-1) and IGF binding protein-1 (IGFBP-1) and -3 (IGFBP-3). Ten healthy female subjects took part in the study. Excretion of the isoflavones genistein, daidzein and equol in urine increased in both phases of the study. No other endpoint was altered in Phase 1. However, in Phase 2, concentrations of IGF-1 and IGFBP-3 were increased by phytoestrogen supplementation [IGF-1, median (IQ range), baseline 155 (123, 258), postweek 265 (228, 360) ng/ml, P

Long-term occlusal and soft-tissue profile outcomes after treatment of Class II Division 1 malocclusion with fixed appliances

Introduction: Our objective was to determine which factors were predictive of good long-term outcomes after fixed appliance treatment of Class II Division 1 malocclusion. Methods: Two hundred seven patients with Class II Division 1 malocclusion were examined in early adulthood at a mean of 4.6 years after treatment with fixed appliances. The peer assessment rating index was used to evaluate dental alignment and occlusal relationships. The soft-tissue profile was assessed with the Holdaway angle. Results: Logistic regression identified 3 pretreatment variables that were predictive of a good facial profile (Holdaway angle) at recall: the lower lip to E-plane distance (P

A Description of the Stationary Wave Pattern of a Marine Craft in Shallow and Intermediate Water Depths

A stationary phase model is used to study supercritical waves generated by high speed ferries. Some general relationships in terms of wave angle, propagation direction, dispersion relationship and depth wavelength relationship are explored and discussed. In particular, it is shown that the wave pattern generated by high speed craft at supercritical speeds depends mainly on the relationship of water depth and ship speed and that the wave patterns are similar in terms of location of crests and troughs for a given depth Froude number. In addition it is found that the far field wave pattern can be described adequately using a single moving point source. The theoretical model compares well with towing tank measurements and full scale data over a range of parameters and hull shapes. The paper also demonstrates that the far field wave pattern at supercritical speeds should be non-dimensionalised by water depth and not hull length unlike it is usually done for subcritical speeds.

Sub-Wavelength Profile 2-D Leaky-Wave Antennas With Two Periodic Layers

A fast and accurate analysis and synthesis technique for high-gain sub-wavelength 2-D Fabry-Perot leaky-wave antennas (LWA) consisting of two periodic metallodielectric arrays over a ground plane is presented. Full-wave method of moments (MoM) together with reciprocity is employed for the estimation of the near fields upon plane wave illumination and the extraction of the radiation patterns of the LWA. This yields a fast and rigorous tool for the characterisation of this type of antennas. A thorough convergence study for different antenna designs is presented and the operation principles of these antennas as well as the radiation characteristics are discussed. Moreover, design guidelines to tailor the antenna profile, the dimensions of the arrays as well as the antenna directivity and bandwidth are provided. A study on the radiation efficiency for antennas with different profiles is also presented and the trade off between directivity and radiation bandwidth is discussed. Numerical examples are given throughout to demonstrate the technique. A finite size antenna model is simulated using commercial software (CST Microstripes 2009) which validates the technique.