Accommodating the diverse cultural needs of cancer patients and their families in palliative care

Cultural issues have become an increasingly important consideration in healthcare. Such cultural issues, however, are underresearched in Australia, especially in palliative care. This study has sought to address this gap, exploring the social construction of cultural issues in palliative care by oncology nurses. A grounded theory approach was used. Semistructured interviews with 7 Australian oncology nurses provided the data for the study. The core category emerging from the study was that of accommodating cultural needs whereby to meet patients' specific cultural requirements, nurses actively found ways to accommodate the needs of patients and their families. This process often included compromise and negotiation whereby limits were set. In addition, the use of cross-cultural communication strategies emerged from the data as an important feature of cultural care. A series of subcategories were also identified as factors that could influence the process by which nurses would accommodate cultural needs.

The association between objectively measured neighborhood features and walking in middle-aged adults

Purpose: To explore the role of the neighborhood environment in supporting walking Design: Cross sectional study of 10,286 residents of 200 neighborhoods. Participants were selected using a stratified two-stage cluster design. Data were collected by mail survey (68.5% response rate). Setting: The Brisbane City Local Government Area, Australia, 2007. Subjects: Brisbane residents aged 40 to 65 years. Measures Environmental: street connectivity, residential density, hilliness, tree coverage, bikeways, and street lights within a one kilometer circular buffer from each resident’s home; and network distance to nearest river or coast, public transport, shop, and park. Walking: minutes in the previous week categorized as < 30 minutes, ≥ 30 < 90 minutes, ≥ 90 < 150 minutes, ≥ 150 < 300 minutes, and ≥ 300 minutes. Analysis: The association between each neighborhood characteristic and walking was examined using multilevel multinomial logistic regression and the model parameters were estimated using Markov chain Monte Carlo simulation. Results: After adjustment for individual factors, the likelihood of walking for more than 300 minutes (relative to <30 minutes) was highest in areas with the most connectivity (OR=1.93, 99% CI 1.32-2.80), the greatest residential density (OR=1.47, 99% CI 1.02-2.12), the least tree coverage (OR=1.69, 99% CI 1.13-2.51), the most bikeways (OR=1.60, 99% CI 1.16-2.21), and the most street lights (OR=1.50, 99% CI 1.07-2.11). The likelihood of walking for more than 300 minutes was also higher among those who lived closest to a river or the coast (OR=2.06, 99% CI 1.41-3.02). Conclusion: The likelihood of meeting (and exceeding) physical activity recommendations on the basis of walking was higher in neighborhoods with greater street connectivity and residential density, more street lights and bikeways, closer proximity to waterways, and less tree coverage. Interventions targeting these neighborhood characteristics may lead to improved environmental quality as well as lower rates of overweight and obesity and associated chromic disease.

Reactive stepping behaviour in response to forward loss of balance predicts future falls in community-dwelling older adults

Background: a fall occurs when an individual experiences a loss of balance from which they are unable to recover. Assessment of balance recovery ability in older adults may therefore help to identify individuals at risk of falls. The purpose of this 12-month prospective study was to assess whether the ability to recover from a forward loss of balance with a single step across a range of lean magnitudes was predictive of falls. Methods: two hundred and one community-dwelling older adults, aged 65–90 years, underwent baseline testing of sensorimotor function and balance recovery ability followed by 12-month prospective falls evaluation. Balance recovery ability was defined by whether participants required either single or multiple steps to recover from forward loss of balance from three lean magnitudes, as well as the maximum lean magnitude participants could recover from with a single step. Results: forty-four (22%) participants experienced one or more falls during the follow-up period. Maximal recoverable lean magnitude and use of multiple steps to recover at the 15% body weight (BW) and 25%BW lean magnitudes significantly predicted a future fall (odds ratios 1.08–1.26). The Physiological Profile Assessment, an established tool that assesses variety of sensori-motor aspects of falls risk, was also predictive of falls (Odds ratios 1.22 and 1.27, respectively), whereas age, sex, postural sway and timed up and go were not predictive. Conclusion: reactive stepping behaviour in response to forward loss of balance and physiological profile assessment are independent predictors of a future fall in community-dwelling older adults. Exercise interventions designed to improve reactive stepping behaviour may protect against future falls.

Women’s perceptions of their lifestyle and quality of life several years after a diagnosis of endometrial cancer

Background Few studies have examined the long-term changes experienced by women treated for endometrial cancer. Objective The objectives of this study were to describe what women perceived important to their lifestyle and quality of life in the years following their diagnosis and to provide new insights that might inform healthcare practice. Methods This was a thematic analysis of 237 open-ended comments from Australian women diagnosed with endometrial cancer 3 to 5 years previously. Results We identified 3 main themes: (1) personal change, in which women spoke about cancer as permanently altering their lives in mostly negative but sometimes positive ways; (2) continuity of former life, which described both the minimal impact of cancer on women's lives and identities and the difficulties negotiating this within the dominant "cancer survivorship" culture; (3) social support, where women wrote about how the quality of their relationships shaped their cancer trajectory. Conclusions While typical "survivorship" issues exist for many women with endometrial cancer (eg, physical, emotional, sexual health changes), a proportion of women will not be focused on their cancer and can be encouraged to form lives and identities that are not situated within the "cancer survivorship" culture. Implications for Practice A network of support, sensitive to women's responses to having cancer, may benefit women's long-term adjustment. Regular standardized assessment of women's needs may facilitate appropriate support for those with concerns, whereas those without concerns could be reassured by health professionals that their experience is normal and shared by other people with cancer. This may encourage women to form lives that are personally meaningful.

Role of big data in the early detection of Ebola and other emerging infectious diseases

The lack of adequate disease surveillance systems in Ebola-affected areas has both reduced the ability to respond locally and has increased global risk. There is a need to improve disease surveillance in vulnerable regions, and digital surveillance could present a viable approach.

Anomalous Temperature dependence of Fermi-edge Singularity in Modulation-doped AlGaAs/InGaAs/GaAs hetero-structures

The temperature and power dependence of Fermi-edge singularity (FES) in high-density two-dimensional electron gas, specific to pseudomorphic AlxGa1-xAs/InyGa1-yAs/GaAs heterostructures is studied by photoluminescence (PL). In all these structures, there are two prominent transitions E11 and E21 considered to be the result of electron-hole recombination from first and second electron sub-bands with that of first heavy-hole sub-band. FES is observed approximately 5 -10 meV below the E21 transition. At 4.2 K, FES appears as a lower energy shoulder to the E21 transition. The PL intensity of all the three transitions E11, FES and E21 grows linearly with excitation power. However, we observe anomalous behavior of FES with temperature. While PL intensity of E11 and E21 decrease with increasing temperature, FES transition becomes stronger initially and then quenches-off slowly (till 40K). Though it appears as a distinct peak at about 20 K, its maximum is around 7 - 13 K.

Propuesta de normativa HACCP para la implementación de un Centro de Industrialización de Carne Avícola en la UNA

El Sistema de Análisis de Riesgos y Puntos Cítricos de Control (HACCP), es una herramienta que se acomoda a cualquier otro sistema, lo único que se pretende con la implantación de este sistema es, procesar alimentos nutritivos, confiables, seguros e inocuos, buscando una alta calidad en el producto, esto significa que el producto procesado este apto para el consumo y que no cause daño o enfermedades a la población que consume el alimento. El presente trabajo tuvo como objeto, sistematizar las normas de implementación del Sistema de Análisis de Riesgos y Puntos Criticos de Control (HACCP) en Nicaragua, para diseñar una propuesta de alternativa para una planta procesadora., específicamente en aves, para la Universidad Nacional Agraria (UNA). Se realizó un estudio visitando las plantas procesadoras de pollo en Nicaragua, las cuales se encuentran certíficadas C{ln el Sistema HACCP, las visitas a esta% plantas consistió en el recorrido de todo el proceso, que va desde la recepción de las aves en las plantas, basta la distribución de los productos terminados, estas vistas se realizaron diariamente, una planta cada día, de cinco de la mañana que inicia la matanza de aves, a cuatro de la tarde que se termina esta matanza, durante seis meses. Las empresas visitadas fueron: Tip-top Km. 16 Y, carretera a Masaya, Pollo Rico en Granada contiguo a la estación de ferrocarril, Indavínsa Pollo Real Km. 26 carretera norte y Pollo Estrella Km. 21 carretera norte. Además se realizó una revisión de literatura, para recabar información y documentación referente al tema en estudio, tal revisión se llevo a cabo en las bibliotecas del MAGFOR y de la biblioteca de la UNA, en ellas se encontró todo lo referente al sistema HACCP , experiencias, principios del sistema, manuales complementarios y todo esto ayudo a desarrollar una propuesta de implementación del Sistema HACCP. Este Sistema es una propuesta racional y sistemática que permite la harmonización de normas y procedimientos que regulan la comercialización de productos alimenticios, simplificando tramites y eliminando barreras para su libre comercio, ya que permite procesar alimentos de alta calidad y aptos para el consumo.

Productividad de la caña de azúcar (Saccharum officinarum) en respuesta a dos formas y épocas de aplicación del nitrógeno en la variedad L-68-40

Se estudió el comportamiento agro-industrial de la variedad L-68-40, de Marzo 1995- Marzo 1996. Se evaluaron las formas y épocas de aplicación del nitrógeno sobre el cultivo de la caña de azúcar (Saccharum sp) . El diseño experimental utilizado fue de Bloques Completos al Azar, las variables analizadas fueron: Germinación, diámetro, altura, población, peso por tallo, rendimiento agrícola, rendimiento industrial y rendimiento agro industrial. Los datos obtenidos se sometieron al análisis de varianza y separación de medias según, Dtmcan al 5 por ciento. Según los resultados obtenidos de las variables evaluadas no se observaron diferencias estadísticas significativas. El mayor rendimiento agrícola fue de 153.16 toneladas de caña por hectárea, este se obtuvo aplicando el fertilizante 75 días después de la siembra. El mayor rendimiento industrial de 89.02 kg de azúcar por toneladas correspondiente a la aplicación del fertilizante de forma fraccionada al momento de la siembra + 75 días después de la siembra. El mayor rendimiento agro-industrial fue obtenido en el tratamiento 75 días después de la siembra con una aplicación de forma total con 14.59 toneladas de azúcar por hectárea.

Rendimiento agroindustrial de la variedad L 68-40 (Saccharum sp.), en respuesta a las aplicaciones de N, P y K, cultivada en un suelo negro en caña planta

El presente trabajo se desarrolló en el Ingenio AGROINSA, de enero de 1995 al mes de marzo de 1996. Se evaluó el rendimiento agro-industrial de la variedad L 68-40 de caña de azúcar (Saccharum sp.), en respuesta a aplicaciones de nitrógeno, fósforo y potasio, cultivada en un suelo negro vertisol, serie Malacatoya (MY). El ensayo se monto de acuerdo a un diseño factorial incompleto en un Bloque Completamente al Azar (BCA), las variables analizadas fueron: Brotación, ahijamiento, diámetro, población, altura, peso promedio de tallo, rendimientos agrícola, industrial y agro-industrial. Los resultados se sometieron a un análisis de varianza y de regresión, además de realizarse una separación de media según la prueba de Cunean al 5 % de margen de error. En todas las variables evaluadas se observó diferencia significativa a excepción del diámetro, peso promedio de tallo y rendimiento industrial, siendo el nitrógeno el elemento que presentó mayor influencia significativa provocando una respuesta directamente proporcional a sus aplicaciones, sin embargo el fósforo y el potasio no influenciaron en la respuesta de las mismas. Las mayores dosis de nitrógeno para producir el 90 % rendimiento agrícola y agro-industrial máximo, obtenida a través del modelo lineal discontinuo fueron de 72.39 y 74.63 kg/ha de nitrógeno respectivamente

A porous bulk metallic glass with unidirectional opening pores

Porous Zr-based bulk metallic glass (PMG) with unidirectional opening pores is prepared by electrochemical etching of tungsten wires of the W/bulk metallic glass (BMG) composites. The porosity and pore size can be controlled by adjusting the tungsten wires. The PMG showed no measurable loss in thermal stability as compared to the monolithic Zr-based BMG by water quenching and is more ductile and softer than the pore-free counterpart. The specific surface area of the PMGs is calculated to be 0.65, 3.96, and 10.54 m(2)/kg for 20, 60, and 80 vol % porosity, respectively. (c) 2007 The Electrochemical Society.

Evaluación comparativa de una ración "Hecha en la finca" con una ración comercial en la alimentación de pollos asaderos

En el local de la Escuela Nacional de Agricultura y ganadería (ENAG) se llevo a cabo un estudio con el propósito de evaluar económicamente una ración comercial y otra elaborada en la finca con pollos asaderos. El estudio tuvo una duración de seis semanas. Se usaron 80 pollos de la zara Vantress Cross son sexar de seis días de nacidos y se dividieron en dos grupos y cada grupo en cuatro lotes, constituyendo estos las repeticiones correspondientes para cada tratamiento. Todos los pollos se vacunaron contra New Castle. Los pollos se pesaron al inicio y final del ensayo y se llevo un registro del alimento consumido en cada grupo. El diseño estadístico utilizado fue completamente al azar. Se encontraron aumentos de pesos significativos P<0.01 con la ración comercial. No se encontró diferencias significativas dentro de cada tratamiento. La ración comercial produjo los mayores beneficios económicos.

意大利威尼托（Veneto）的刺叶栎林-植物社会学生物多样性研究

刺叶栎( Quercus ilex L．)是地中海的常绿树种，属于古老的第三纪植物区系成份。本文根据苏黎世——蒙特利尔学派的植被学基本原理，全面地研究了分布在整个威尼托(Veneto)大区的剌叶栎林，详细研究刺叶栎林的群落组成、结构及类型划分。同时，对威尼托的刺叶栎林同北京山区的栎林进行了比较研究。最后，着重研究了威尼托刺叶栎林的生物多样性。 威尼托的刺叶栎林主要分布在亚得里亚海沿岸（包括Foci del Tagtiamento和Bosco Nordio e Rosolina Mare两地）、Lago di Garda和Colli Euganei。 在气候上，亚得里亚海沿岸属于半地中海气候。加尔达湖区域(Laqo di Garda)则是接近欧洲中部的大陆性气候，且维持半地中海的气候特点。Co t l i Euganei是这两地气候的过渡类型，且更接近亚得里亚海沿岸的类型。 在亚得里亚海沿岸的刺叶栎林可以分为三类，第一类(I)是一些矮树丛，这是Fraxinus ornus和Quercus ilex混交林的前身，较干旱。第二类群落(II)缺少乔木层，灌木层是由一些盖度不大的刺叶栎代替，更干旱。第三类群落(Ⅲ)是一群在外貌上相同的成熟群落．Fraxinus ornus和Quercus ilex得到充分发展，较中生。 在加尔达湖区的刺叶栎林可划分为三类。第一类群落(I)代表一组耐旱、开敞的矮树丛，含有Sesterio Variae-Ostryelum群丛的特征种，这一类可划分为SesLerio Variae-Ostryetum群 丛，土壤贫脊和干旱。第二类群落(Ⅱ)代表一类较郁闭的矮树丛，含有较多的Prunetalia群落目的成份，土壤较贫脊。第三类群(Ⅲ)代表一类郁闭的群落，乔木具有很大的密度因而林下灌木不能充分发展。SesLerio Variae-Ostryetum群丛和Prunetalia群落目的成份均不多。 在Colli Euganei的刺叶栎林可划分为二类。第一类群落(I)是一些不郁闲的矮树林组成。大体上分为地中海旱生栎林和地中海假灌丛。第二类群落(II)代表了较中生状态的植被，刺叶标种群绝对郁闭。 北京地处华北大平原的西北部。北京山地的气候为温带陆地性季风气候，其地带性的落叶阔叶林是以栎林为典型。虽然这些栎林同意大利威尼托刺叶栎林是两种不同的森林类型，但两者之间是存在着一定的联系。其共有的科有20个，共有属有11个。他们在植物组成中，以禾本科，蔷薇科和豆科的植物种类为最多。在乔木层中，他们都是以壳斗科的栎属(Quercus)为优势，其中木犀科的白蜡属(Fraxinus)和槭树属(Acer)较多。 本文对威尼托大区刺叶栎林的物种多度分布格局进行了全面探讨，计算出刺叶栎林的几何分布模型、Broken-stick分布模型、Log分布模型、Log-normat分布模型等四种物种多度分布的理论模型，并将这些理论分布模型用“序列／多度”图解和“多度／频度”图解表示出来。其中，几何分布模型．Broken-stick1分布模型用“序列／多度”图解表示。Broken-stick2分布模型、Log分布模型、Log-normal分布模型用“多度／频度”图解表示。 对上述四个物种多度的理论分布同实际现察的物种多度分布进行X2分析，在5％的显著性水平上，对整个威托大区的刺叶 栎林，几何分布模型最能代表其物种多度分布，显著性最大;Log-normal分布模型也可以用来代表威尼托刺叶标妹的物种多度分布，其显著性次于几何分布模型的显著性。这表明威尼托的刺叶栎林尚处于演替的早期阶段，这些刺叶栎林曾受到严重破坏，现正在恢复。 通过比较Foci del Tagtiamento和Bosco Nordio加尔达湖区、Colli Euganei四个地方刺叶栎林的物种多度的几何分布模型和Log-normal分布模型，显示出Lago di Garda（加尔达湖区）的刺叶栎林生物多样性最好、Foci del Tagtiamento刺叶栎林生物多样性较好．Bosco Nordio的剌叶栎林生物多样性较差．Colli Euganei的刺叶栎林生物多样性最差。 再利用多样性指数计算全部威尼托大区剌叶栎林的生物多样性。计算的多样性指数有丰富度指数（包括Margalef指数、Men-hinick指数、Monk指数）、多样性指数(Shannon信息指数、Bri llouin个息指数、Gini指数、PIE指数、Mcintosh指数)、优势度指数(Berger-Parker指数、Simpson指数)、均一度指数(Pielou均一度指数、Brillouin均一度指数，PIE的V’均一度指数．PIE的V均一度指数，N2的V’均一度指数，N2的V均一度指数，Mclntosh均一度指数，Hill的F10均一度指数，Hill的E21均一度指数，Hill的F21的一度指数）。通过比较丰富度指数，多样性指数、均一度指数与优势度之间的关系，结果，Simpson优势度指数同Men-hinick物种丰富度指数、Shannon信息指数、Bril-louin信息指数、Pielou均一度指数，Brillouin均一度指数，Mcintosh均一度指数、PIE的V’均一度指数呈负相关关系，因此，上述生物多样性指数可以较好地反映威尼托大区刺叶栎林的生物多样性。反映出的结果是：加尔达湖区刺叶栎林生物多样性最好，Foci del Tagtiamento刺叶栎林生物多样性较好，Bosco Nordio的剌叶栎林生物多样性较差．Colli Euganei的刺叶栎林生物多样性最差。 生物多样性的研究显示出生物多样性同生境状况的密切联系。往往受人为干扰严重的群落生物多样性低、如Coli Euganei和亚得里亚海岸刺叶栋林;而受人为破坏较轻的群落其生物多样性高，如加尔达湖区刺叶栎。 生物多样性的研究还显示出生物多样性同群落演替的发展阶段密切相关，在群落演替初期，由于缺乏优势种，而又有大量物种侵入，物多样性相对较高。在群落演替中期，由于形成了一个或几个优势种，优势度的增加导致了生物多样性相对减低。如Foci del Tagtiamento刺叶栎林生物多样性高于Bosco Nordio刺叶栎林的生物多样性。到演替后期，随着更多物种的侵入，群落结构的复杂化、生物多样性又将逐步提高。

Proposed role for COUP-TFII in regulating fetal Leydig cell steroidogenesis, perturbation of which leads to masculinization disorders in rodents

Reproductive disorders that are common/increasing in prevalence in human males may arise because of deficient androgen production/action during a fetal 'masculinization programming window'. We identify a potentially important role for Chicken Ovalbumin Upstream Promoter-Transcription Factor II (COUP-TFII) in Leydig cell (LC) steroidogenesis that may partly explain this. In rats, fetal LC size and intratesticular testosterone (ITT) increased ~3-fold between e15.5-e21.5 which associated with a progressive decrease in the percentage of LC expressing COUP-TFII. Exposure of fetuses to dibutyl phthalate (DBP), which induces masculinization disorders, dose-dependently prevented the age-related decrease in LC COUP-TFII expression and the normal increases in LC size and ITT. We show that nuclear COUP-TFII expression in fetal rat LC relates inversely to LC expression of steroidogenic factor-1 (SF-1)-dependent genes (StAR, Cyp11a1, Cyp17a1) with overlapping binding sites for SF-1 and COUP-TFII in their promoter regions, but does not affect an SF-1 dependent LC gene (3β-HSD) without overlapping sites. We also show that once COUP-TFII expression in LC has switched off, it is re-induced by DBP exposure, coincident with suppression of ITT. Furthermore, other treatments that reduce fetal ITT in rats (dexamethasone, diethylstilbestrol (DES)) also maintain/induce LC nuclear expression of COUP-TFII. In contrast to rats, in mice DBP neither causes persistence of fetal LC COUP-TFII nor reduces ITT, whereas DES-exposure of mice maintains COUP-TFII expression in fetal LC and decreases ITT, as in rats. These findings suggest that lifting of repression by COUP-TFII may be an important mechanism that promotes increased testosterone production by fetal LC to drive masculinization. As we also show an age-related decline in expression of COUP-TFII in human fetal LC, this mechanism may also be functional in humans, and its susceptibility to disruption by environmental chemicals, stress and pregnancy hormones could explain the origin of some human male reproductive disorders.