68 research outputs found

    A qualitative study of cardiovascular disease risk communication in NHS Health Check using different risk calculators: protocol for the RIsk COmmunication in NHS Health Check (RICO) study. BMC family practice, 20(1), 11.

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    Background NHS Health Check is a national cardiovascular disease (CVD) risk assessment programme for 40–74 year olds in England, in which practitioners should assess and communicate CVD risk, supported by appropriate risk-management advice and goal-setting. This requires effective communication, to equip patients with knowledge and intention to act. Currently, the QRISK®2 10-year CVD risk score is most common way in which CVD risk is estimated. Newer tools, such as JBS3, allow manipulation of risk factors and can demonstrate the impact of positive actions. However, the use, and relative value, of these tools within CVD risk communication is unknown. We will explore practitioner and patient CVD risk perceptions when using QRISK®2 or JBS3, the associated advice or treatment offered by the practitioner, and patients’ responses. Methods RIsk COmmunication in NHS Health Check (RICO) is a qualitative study with quantitative process evaluation. Twelve general practices in the West Midlands of England will be randomised to one of two groups: usual practice, in which practitioners use QRISK®2 to assess and communicate CVD risk; intervention, in which practitioners use JBS3. Twenty Health Checks per practice will be video-recorded (n = 240, 120 per group), with patients stratified by age, gender and ethnicity. Post-Health Check, video-stimulated recall (VSR) interviews will be conducted with 48 patients (n = 24 per group) and all practitioners (n = 12–18), using video excerpts to enhance participant recall/reflection. Patient medical record reviews will detect health-protective actions in the first 12-weeks following a Health Check (e.g., lifestyle referrals, statin prescription). Risk communication, patient response and intentions for health-protective behaviours in each group will be explored through thematic analysis of video-recorded Health Checks (using Protection Motivation Theory as a framework) and VSR interviews. Process evaluation will include between-group comparisons of quantitatively coded Health Check content and post-Health Check patient outcomes. Finally, 10 patients with the most positive intentions or behaviours will be selected for case study analysis (using all data sources). Discussion This study will produce novel insights about the utility of QRISK®2 and JBS3 to promote patient and practitioner understanding and perception of CVD risk and associated implications for patient intentions with respect to health-protective behaviours (and underlying mechanisms). Recommendations for practice will be developed

    The sense of smell, its signalling pathways, and the dichotomy of cilia and microvilli in olfactory sensory cells

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    Smell is often regarded as an ancillary perception in primates, who seem so dominated by their sense of vision. In this paper, we will portray some aspects of the significance of olfaction to human life and speculate on what evolutionary factors contribute to keeping it alive. We then outline the functional architecture of olfactory sensory neurons and their signal transduction pathways, which are the primary detectors that render olfactory perception possible. Throughout the phylogenetic tree, olfactory neurons, at their apical tip, are either decorated with cilia or with microvilli. The significance of this dichotomy is unknown. It is generally assumed that mammalian olfactory neurons are of the ciliary type only. The existance of so-called olfactory microvillar cells in mammals, however, is well documented, but their nature remains unclear and their function orphaned. This paper discusses the possibility, that in the main olfactory epithelium of mammals ciliated and microvillar sensory cells exist concurrently. We review evidence related to this hypothesis and ask, what function olfactory microvillar cells might have and what signalling mechanisms they use

    PIK3CA mutations are frequent in esophageal squamous cell carcinoma associated with chagasic megaesophagus and are associated with a worse patient outcome

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    Chronic diseases such as chagasic megaesophagus (secondary to Chagas' disease) have been suggested as etiological factors for esophageal squamous cell carcinoma; however, the molecular mechanisms involved are poorly understood.Background Chronic diseases such as chagasic megaesophagus (secondary to Chagas’ disease) have been suggested as etiological factors for esophageal squamous cell carcinoma; however, the molecular mechanisms involved are poorly understood. Objective We analyzed hotspot PIK3CA gene mutations in a series of esophageal squamous cell carcinomas associated or not with chagasic megaesophagus, as well as, in chagasic megaesophagus biopsies. We also checked for correlations between the presence of PIK3CA mutations with patients’ clinical and pathological features. Methods The study included three different groups of patients: i) 23 patients with chagasic megaesophagus associated with esophageal squamous cell carcinoma (CM/ESCC); ii) 38 patients with esophageal squamous cell carcinoma not associated with chagasic megaesophagus (ESCC); and iii) 28 patients with chagasic megaesophagus without esophageal squamous cell carcinoma (CM). PIK3CA hotspot mutations in exons 9 and 20 were evaluated by PCR followed by direct sequencing technique. Results PIK3CA mutations were identified in 21.7% (5 out of 23) of CM/ESCC cases, in 10.5% (4 out of 38) of ESCC and in only 3.6% (1 case out of 28) of CM cases. In the CM/ESCC group, PIK3CA mutations were significantly associated with lower survival (mean 5 months), when compared to wild-type patients (mean 2.0 years). No other significant associations were observed between PIK3CA mutations and patients’ clinical features or TP53 mutation profile. Conclusion This is the first report on the presence of PIK3CA mutations in esophageal cancer associated with chagasic megaesophagus. The detection of PIK3CA mutations in benign chagasic megaesophagus lesions suggests their putative role in esophageal squamous cell carcinoma development and opens new opportunities for targeted-therapies for these diseases.CAPES and FAPESP - Fundação de Amparo à Pesquisa do Estado de São Paulo [Grant number 2015/20077–3 to FFM] and Barretos Cancer Hospital internal research funds (PAIP)info:eu-repo/semantics/publishedVersio

    Neurofilament depletion improves microtubule dynamics via modulation of Stat3/stathmin signaling

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    In neurons, microtubules form a dense array within axons, and the stability and function of this microtubule network is modulated by neurofilaments. Accumulation of neurofilaments has been observed in several forms of neurodegenerative diseases, but the mechanisms how elevated neurofilament levels destabilize axons are unknown so far. Here, we show that increased neurofilament expression in motor nerves of pmn mutant mice, a model of motoneuron disease, causes disturbed microtubule dynamics. The disease is caused by a point mutation in the tubulin-specific chaperone E (Tbce) gene, leading to an exchange of the most C-terminal amino acid tryptophan to glycine. As a consequence, the TBCE protein becomes instable which then results in destabilization of axonal microtubules and defects in axonal transport, in particular in motoneurons. Depletion of neurofilament increases the number and regrowth of microtubules in pmn mutant motoneurons and restores axon elongation. This effect is mediated by interaction of neurofilament with the stathmin complex. Accumulating neurofilaments associate with stathmin in axons of pmn mutant motoneurons. Depletion of neurofilament by Nefl knockout increases Stat3-stathmin interaction and stabilizes the microtubules in pmn mutant motoneurons. Consequently, counteracting enhanced neurofilament expression improves axonal maintenance and prolongs survival of pmn mutant mice. We propose that this mechanism could also be relevant for other neurodegenerative diseases in which neurofilament accumulation and loss of microtubules are prominent features

    The New Planning Approach and Criteria Used for Sustainable Forest Management in Turkey

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    This chapter outlines a new approach to planning for multifunctional forest management objectives in Turkey. It describes the term 'functional planning', and the criteria that should be used to determine sustainable forest management in Turkey. The functional planning approach was developed to better balance demand for timber production as well as the protective functions of the forests such as erosion control, water yield, visual effect, recreational use, wildlife habitats and biodiversity

    Fragmentation effects on the structure of some urban forests in Istanbul

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    Forest fragmentation is the separation or division of large forests into smaller units. Areas with non-forest lands significantly threaten the health, function, and value of the remaining forest. This study describes the effects of fragmentation on diversity of forest in the city of Istanbul. We obtained inventory data from local forest management and silvicultural plans (2002-2007). The data were used to determine the spatial variation in forest structure and biodiversity across six urban forest fragments in Istanbul, Turkey. We calculated a core set of patch- and class-level metrics in order to predict forest basal area within sample plots. We tested a number of regression models and employed the best-fitted model to extrapolate forest diversity across the urban forest fragments. Results indicate consistent relationship between spatial and silvicultural variables, suggesting the impact of fragmentation on the forest structure and biodiversity in Istanbul. Species richness of green spaces in urban areas was higher when compared to that of peri-urban areas. The location and the sizes of urban forests were associated with difference in societal expectations from these areas. As a consequence of the expectations, there was a change in forest structure in Istanbul. This study could be conducted for any other urban areas including large growing cities and megalopolis

    Aging Drosophila melanogaster Display Altered Pre- and Postsynaptic Ultrastructure at Adult Neuromuscular Junctions

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    Although age-related changes in synaptic plasticity are an important focus within neuroscience, little is known about ultrastructural changes of synaptic morphology during aging. Here we report how aging affects synaptic ultrastructure by using fluorescence and electron microscopy at the adult Drosophila neuromuscular junction (NMJ) of ventral abdominal muscles. Mainly four striking morphological changes of aging NMJs were revealed. 1) Bouton size increases with proportionally rising number of active zones (AZs). 2) Synaptic vesicle density at AZs is increased in old flies. 3) Late endosomes, cisternae, and multivesicular bodies accumulate in the presynaptic terminal, and vesicles accumulate between membranes of the terminal bouton and the subsynaptic reticulum. 4) The electron-dense pre- and postsynaptic apposition is expanded in aging NMJs, which is accompanied by an expansion of the postsynaptic glutamate receptor fields. These findings suggest that aging is possibly accompanied by impaired synaptic vesicle release and recycling and a potentially compensatory expansion of AZs and postsynaptic densities. (C) 2015 Wiley Periodicals, Inc

    Separation of citrus plantations from forest cover using landsat imagery

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    The development of a National Forest Inventory (NFI) process is mandatory for Turkey as a country in the process of negotiations for European Union membership. Research is currently being under-taken into developing an appropriate model for a NFI suitable for Turkey's forest conditions. This study was undertaken within the framework of a cooperative project that explores the potential applications of satellite data for the development of a Turkish NFI. The main goal of the study is to determine the ability to discriminate between citrus orchards and other agricultural areas from forest cover using Landsat ETM+ data in a selected area in the Mediterranean Region of Turkey

    Comparison of Quickbird-2 and Landsat-7 ETM+ data for mapping of vegetation cover in Fethiye-Kumluova coastal dune in the Mediterranean region of Turkey

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    Dune vegetation plays an important socio-economic role in some coastal areas of Turkey's Mediterranean region as it prevents sand encroaching on residual areas, agricultural fields and sites of historical significance. These areas are also vital for biodiversity conservation due to the rare plant species and habitats found within dune ecosystems. In order to initiate the necessary protective measures to maintain these sensitive biotopes, dune areas must be carefully mapped and then monitored at regular, predefined time intervals. Vegetation mapping using remotely sensed data is often the primary source of information on current sand dune conditions and is used as a baseline for future management options. The objective of this study was to determine the effectiveness of Quickbird-2 data for the stratification of plant communities in the Kumluova sand dunes, and to compare the results with a classification map derived from Landsat-7 Enhanced Thematic Mapper (ETM+) data. The overall classification accuracy using Quickbird data with 10 classes was found to be 82.2%, with the Kappa coefficient of 0.80. Landsat classification produced an overall accuracy of 75.7% and a Kappa coefficient of 0.72 for 8 land use classes. The results indicated that Quickbird and Landsat ETM+ satellite data can be employed for different management purposes within dune areas. Quickbird imagery may be used for vegetation cover mapping for tactical forest management planning purposes as a substitute for aerial photography, while Landsat imagery may be used for the localisation of afforestation and deforested areas within dune ecosystems between successive years for strategic planning purposes
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