Health-related quality of life before and after management in adults referred to otolaryngology: rospective national study

Objective: An assessment of the effect of otolaryngological management on the health-related quality of life of patients. Design: Application of the Health Utilities Index mark 3 (HUI-3) before and after treatment; application of the Glasgow Benefit Inventory (GBI) after treatment. Setting: Six otolaryngological departments around Scotland. Participants: A 9005 adult patients referred to outpatient clinics. Main outcome measures: Complete HUI-3 data was collected from 4422 patients; complete GBI data from 4235; complete HUI-3 and GBI data from 3884. Results: The overall change in health related quality of life from before to after management was just +0.02. In the majority of subgroups of data (classified by type of management) there was essentially no change in HUI-3 score. The major exceptions were those patients provided with a hearing aid (mean change 0.08) and those whose problem was managed surgically (mean change 0.04). The mean GBI score was 5.3 which is low. Those managed surgically reported a higher GBI score of 13.0. Conclusion: We found that patients treated surgically or given a hearing aid reported a significant improvement in their health related quality of life after treatment in otolaryngology departments. In general, patients treated in other ways reported no significant improvement. We argue that future research should look carefully at patient groups where there is unexpectedly little benefit from current treatment methods and consider more effective methods of management

Mapping the disease-specific LupusQoL to the SF-6D

Purpose To derive a mapping algorithm to predict SF-6D utility scores from the non-preference-based LupusQoL and test the performance of the developed algorithm on a separate independent validation data set. Method LupusQoL and SF-6D data were collected from 320 patients with systemic lupus erythematosus (SLE) attending routine rheumatology outpatient appointments at seven centres in the UK. Ordinary least squares (OLS) regression was used to estimate models of increasing complexity in order to predict individuals’ SF-6D utility scores from their responses to the LupusQoL questionnaire. Model performance was judged on predictive ability through the size and pattern of prediction errors generated. The performance of the selected model was externally validated on an independent data set containing 113 female SLE patients who had again completed both the LupusQoL and SF-36 questionnaires. Results Four of the eight LupusQoL domains (physical health, pain, emotional health, and fatigue) were selected as dependent variables in the final model. Overall model fit was good, with R2 0.7219, MAE 0.0557, and RMSE 0.0706 when applied to the estimation data set, and R2 0.7431, MAE 0.0528, and RMSE 0.0663 when applied to the validation sample. Conclusion This study provides a method by which health state utility values can be estimated from patient responses to the non-preference-based LupusQoL, generalisable beyond the data set upon which it was estimated. Despite concerns over the use of OLS to develop mapping algorithms, we find this method to be suitable in this case due to the normality of the SF-6D data

The aetiology of social deficits within mental health disorders:The role of the immune system and endogenous opioids

The American National Institute for Mental Health (NIMH) has put out a set of research goals that include a long-term plan to identify more reliable endogenous explanations for a wide variety of mental health disorders (Insel, 2013). In response to this, we have identified a major symptom that underlies multiple mental health disorders – social bonding dysfunction. We suggest that endogenous opioid abnormalities can lead to altered social bonding, which is a symptom of various mental health disorders, including depression, schizophrenia and ASD. This article first outlines how endogenous opioids play a role in social bonding. Then we show their association with the body’s inflammation immune function, and review recent literature linking inflammation to mental health ‘immunophenotypes’. We finish by explaining how these immunophenotypes may be caused by alterations in the endogenous opioid system. This is the first overview of the role of inflammation across multiple disorders where we provide a biochemical explanation for why immunophenotypes might exist across diagnoses. We propose a novel mechanism of how the immune system may be causing ‘sickness-type’ behaviours (fatigue, appetite change, social withdrawal and inhibited motivation) in those who have these immunophenotypes. We hope that this novel aetiology can be used as a basis for future research in mental health

Prior Mating Experience Modulates the Dispersal of Drosophila in Males More Than in Females

Cues from both an animal’s internal physiological state and its local environment may influence its decision to disperse. However, identifying and quantifying the causative factors underlying the initiation of dispersal is difficult in uncontrolled natural settings. In this study, we automatically monitored the movement of fruit flies and examined the influence of food availability, sex, and reproductive status on their dispersal between laboratory environments. In general, flies with mating experience behave as if they are hungrier than virgin flies, leaving at a greater rate when food is unavailable and staying longer when it is available. Males dispersed at a higher rate and were more active than females when food was unavailable, but tended to stay longer in environments containing food than did females. We found no significant relationship between weight and activity, suggesting the behavioral differences between males and females are caused by an intrinsic factor relating to the sex of a fly and not simply its body size. Finally, we observed a significant difference between the dispersal of the natural isolate used throughout this study and the widely-used laboratory strain, Canton-S, and show that the difference cannot be explained by allelic differences in the foraging gene

A database solution for the quantitative characterisation and comparison of deep-marine siliciclastic depositional systems

In sedimentological investigations, the ability to conduct comparative analyses between deep-marine depositional systems is hindered by the wide variety in methods of data collection, scales of observation, resolution, classification approaches and terminology. A relational database, the Deep-Marine Architecture Knowledge Store (DMAKS), has been developed to facilitate such analyses, through the integration of deep-marine sedimentological data collated to a common standard. DMAKS hosts data on siliciclastic deep-marine system boundary conditions, and on architectural and facies properties, including spatial, temporal and hierarchical relationships between units at multiple scales. DMAKS has been devised to include original and literature-derived data from studies of the modern sea-floor, and from ancient successions studied in the sub-surface and in outcrop. The database can be used as a research tool in both pure and applied science, allowing the quantitative characterisation of deep-marine systems. The ability to synthesise data from several case studies and to filter outputs on multiple parameters that describe the depositional systems and their controlling factors enables evaluation of the degree to which certain controls affect sedimentary architectures, thereby testing the validity of existing models. In applied contexts, DMAKS aids the selection and application of geological analogues to hydrocarbon reservoirs, and permits the development of predictive models of reservoir characteristics that account for geological uncertainty. To demonstrate the breadth of research applications, example outputs are presented on: (i) the characterisation of channel geometries, (ii) the hierarchical organisation of channelised and terminal deposits, (iii) temporal trends in the deposition of terminal lobes, (iv) scaling relationships between adjacent channel and levee architectural elements, (v) quantification of the likely occurrence of elements of different types as a function of the lateral distance away from an element of known type, (vi) proportions and transition statistics of facies in elements and beds, (vii) variability in net-to-gross ratios among element types

Photochemically active DNA-intercalating ruthenium and related complexes – insights by combining crystallography and transient spectroscopy

Recent research on the study of the interaction of ruthenium polypyridyl compounds and defined sequence nucleic acids is reviewed. Particular emphasis is paid to complexes [Ru(LL)2(Int)]2+ containing potentially intercalating ligands (Int) such as dipyridophenazine (dppz), which are known to display light-switching or photo-oxidising behaviour, depending on the nature of the ancillary ligands. X-ray crystallography has made a key contribution to our understanding, and the first complete survey of structural results is presented. These include sequence, enantiomeric, substituent and structural specificities. The use of ultrafast transient spectrocopic methods to probe the ultrafast processes for complexes such as [Ru(TAP)2(dppz)]2+ and [Ru(phen)2(dppz)]2+ when bound to mixed sequence oligonucleotides are reviewed with particular attention being paid to the complementary advantages of transient (visible) absorption and time-resolved (mid) infra-red techniques to probe spectral changes in the metal complex and in the nucleic acid. The observed photophysical properties are considered in light of the structural information obtained from X-ray crystallography. In solution, metal complexes can be expected to bind at more than one DNA step, so that a perfect correlation of the photophysical properties and factors such as the orientation or penetration of the ligand into the intercalation pocket should not be expected. This difficulty can be obviated by carrying out TRIR studies in the crystals. Dppz complexes also undergo insertion, especially with mismatched sequences. Future areas for study such as those involving non-canonical forms of DNA, such as G-quadruplexes or i-motifs are also briefly considered

Mechanistic implications of the active species involved in the oxidation of hydrocarbons by iron complexes of pyrazine-2-carboxylic acid

The reactivity towards H2O2 of the complexes [Fe(pca)2(py)2]·py (1) and Na2{[Fe(pca3)]2O}·2H2O·CH3CN (2) (where pca− is pyrazine-2-carboxylate) and their catalytic activity in the oxidation of hydrocarbons is reported. Addition of H2O2 to 1 results in the formation of a dinuclear Fe(III)–(µ-O)–Fe(III) species characterized spectroscopically and by cyclic voltammetry. By contrast, treatment of 2 with H2O2 results in the formation of mononuclear iron(II) complexes, [Fe(pca)2(solvent)2]. The experimental results indicate that the catalytic activity of the starting complexes 1 and 2 is strongly dependent on the species formed in solution.

The impact of the Great Exhibition of 1851 on the development of technical education during the second half of the nineteenth century

This paper examines the contribution made by the mechanics’ institute movement in Britain just prior to, and following, the opening of the Great Exhibition of 1851 in London. It argues that far from making little contribution to education, as often portrayed by historians, the movement was ideally positioned to respond to the findings of the Exhibition, which were that foreign goods on display were often more advanced than those produced in Britain. The paper highlights, through a regional study, how well suited mechanics’ institutes were in organising their own exhibitions, providing the idea of this first international exhibition. Subsequently, many offered nationally recognised technical subject examinations through relevant education as well as informing government commissions, prior to the passing of the Technical Instruction Acts in 1889 and the Local Taxation Act of 1890. These acts effectively put mechanics’ institutes into state ownership as the first step in developing further education for all in Britai

First Neutrino Observations from the Sudbury Neutrino Observatory

The first neutrino observations from the Sudbury Neutrino Observatory are presented from preliminary analyses. Based on energy, direction and location, the data in the region of interest appear to be dominated by 8B solar neutrinos, detected by the charged current reaction on deuterium and elastic scattering from electrons, with very little background. Measurements of radioactive backgrounds indicate that the measurement of all active neutrino types via the neutral current reaction on deuterium will be possible with small systematic uncertainties. Quantitative results for the fluxes observed with these reactions will be provided when further calibrations have been completed.Comment: Latex, 7 pages, 10 figures, Invited paper at Neutrino 2000 Conference, Sudbury, Canada, June 16-21, 2000 to be published in the Proceeding