Intermolecular interactions in the chiral and racemic forms of 3-hydroxy-2-(1-oxoisoindolin-2-yl)butanoic acid derived from threonine

The title compounds, C₁₂H₁₃NO₄, are derived from L-threonine and DL-threonine, respectively. Hydrogen bonding in the chiral derivative, (2S/3R)-3-hydroxy-2-(1-oxoisoindolin-2-yl)butanoic acid, consists of O-Hacid...Oalkyl-H...O=Cindole chains [O...O 2.659 (3) and 2.718 (3) Å], Csp³-H...O and three C-H...πarene interactions. In the (2R,3S/2S,3R) racemate, conventional carboxylic acid hydrogen bonding as cyclical (O-H...O=C)₂ [graph set R₂²(8)] is present, with Oalkyl-H...O=Cindole, Csp³-H...O and C-H...πarene interactions. The COOH group geometry differs between the two forms, with C-O, C=O, C-C-O and C-C=O bond lengths and angles of 1.322 (3) and 1.193 (3) Å, and 109.7 (2) and 125.4 (3)°, respectively, in the chiral structure, and 1.2961 (17) and 1.2210 (18) Å, and 113.29 (12) and 122.63 (13)°, respectively, in the racemate structure. The O-C=O angles of 124.9 (3) and 124.05 (14)° are similar. The differences arise from the contrasting COOH hydrogen-bonding environments in the two structures

The Impact of Prostate Cancer on Survivors\u27 Sense of Meaning in Life

Research has shown that meaning in life is a universal human need, regardless of cultural identity or education. This research study investigated how the encounter with prostate cancer impacted men\u27s sense of well-being and what they considered meaningful in life. An interpretative phenomenological research design was used because of its descriptive nature and its focus on the individual\u27s perspective. The sample included 6 men between the ages of 18 and 65 who had been out of treatment for 1 year. Participants completed essays about their perceptions and experiences over 3 periods of time: before diagnosis, during treatment, and as survivors. The analysis concentrated on exploring participants\u27 perceptions; identifying themes, commonalities and discrepancies in the data; and drawing comparisons between participants\u27 definitions for meaning in life with the meaning making model of Park and Folkman. Study results addressed issues including a lack of information about side effects and the depth of the mental and emotional toll taken not only on the patients but also on people around them. Social change implications include the importance of (a) educating men with prostate cancer about the mental and physical health challenges they may face as they undergo treatment; (b) encouraging them to reach out for support (including professional services) should they encounter psychological difficulties over the course of dealing with their illness; and, (c) providing them with opportunities to speak about the mental, emotional, physical, and relational challenges they have faced and may still be facing in their lives as a consequence of the disease and its associated treatments

Commercial gaming devices for stroke upper limb rehabilitation: the stroke survivor experience

Introduction Approximately 30% of stroke survivors experience an upper limb impairment, which impacts on participation and quality of life. Gaming devices (Nintendo Wii) are being incorporated into rehabilitation to improve function. We explored the stroke survivor experience of gaming as an upper limb intervention. Methods Semi-structured, individual interviews with stroke survivors living within the UK were completed. Interviews were audio-recorded, transcribed verbatim and analysed using Framework methods. Transcripts were coded and summarised into thematic charts. Thematic charts were refined during analysis until the final framework emerged. Results We captured experiences of 12 stroke survivors who used Nintendo Wii. Gaming devices were found to be acceptable for all ages but varying levels of enthusiasm existed. Enthusiastic players described gaming as having a positive impact on their motivation to engage in rehabilitation. For some, this became a leisure activity, encouraging self-practice. Non-enthusiastic players preferred sports to gaming. Conclusion An in-depth account of stroke survivor experiences of gaming within upper limb rehabilitation has been captured. Suitability of gaming should be assessed individually and stroke survivor abilities and preference for interventions should be taken into consideration. There was no indication that older stroke survivors or those with no previous experience of gaming were less likely to enjoy the activity

Promising Practices in Preconception Care for Women at Risk for Poor Health and Pregnancy Outcomes

Objectives: Two programs targeting urban African-American women are presented as promising models for preconception care, which includes interconception care. Methods: The Grady Memorial Hospital Interpregnancy Care (IPC) Program in Atlanta, Georgia, and the Magnolia Project in Jacksonville, Florida, are described. The IPC program aims to investigate whether IPC can improve the health status, pregnancy planning and child spacing of women at risk of recurrent very low birthweight (VLBW). The Magnolia Project aims to reduce key risks in women of childbearing age, such as lack of family planning and repeat sexually transmitted diseases (STDs), through its case management activities. Results: Seven out of 21 women in the IPC were identified as having a previously unrecognized or poorly managed chronic disease. 21/21 women developed a reproductive plan for themselves, and none of the 21 women became pregnant within nine months following the birth of their VLBW baby. The Magnolia Project had a success rate of greater than 70% in resolving the key risks (lack of family planning, repeat STDs) among case management participants. The black to white infant mortality (IM) ratio was better for the babies born to women managed in the Magnolia Project compared to the same ration for the United States. Conclusions: Preconception care targeted to African-American women at risk for poor birth outcomes appears to be effective when specific risk factors are identified and interventions are appropriate. Outreach to women at risk and case management can be effective in optimizing the woman's health and subsequent reproductive health outcomes

Understanding vulnerabilities and risk in the development of market based approaches

Progress towards resilient and sustainable development is continuous and constantly shifting as circumstances, contextual experiences and systems change. In many countries there are humanitarian and development activities taking place at the same time, yet our approaches within these areas can still be quite separated in terms of planning, implementation and monitoring. Yet traditionally quite different populations benefit from humanitarian and development interventions. Interest in the role of markets in both humanitarian and development contexts continues to grow based on the understanding that markets need to work for marginalised and vulnerable populations. Vulnerability will have an impact on the way that people can interact with market systems and trying to understand markets in relation to both personal vulnerabilities and vulnerable and fragile contexts requires a new approach, linking humanitarian and development actions more systematically

Using Needs Assessment to Understand Continuing Disability in Patients with Enduring Mental Illness. Implications for Considerations of Service Development

Particular strengths of the MRC Needs for Care Assessment Schedule have been used to investigate the treatment status of patients with persistent psychiatric disability in ways that other needs assessment tools are unable to. One hundred and seventy-nine such patients from three settings; a private sector psychiatric hospital, two public sector day hospitals situated in the same town, and a high security hospital, were found to have a high level of need. Although there were differences between settings, overall these needs were well met in all three. The high level of persistent disability found amongst these patients could not be attributed to failure on the part of those treating them to use the best available methods, or to failures to comply or engage with treatment on the patient's part. In some two thirds of instances persistent disability was best explained by the fact that even the most suitable available treatments have to be considered only partially effective

Multiplex ligation-dependent probe amplification (MLPA) analysis is an effective tool for the detection of novel intragenic PLA2G6 mutations: Implications for molecular diagnosis

Phospholipase associated neurodegeneration (PLAN) comprises a heterogeneous group of autosomal recessive neurological disorders caused by mutations in the PLA2G6 gene. Direct gene sequencing detects 85% mutations in infantile neuroaxonal dystrophy. We report the novel use of multiplex ligation-dependent probe amplification (MLPA) analysis to detect novel PLA2G6 duplications and deletions. The identification of such copy number variants (CNVs) expands the PLAN mutation spectrum and may account for up to 12.5% of PLA2G6 mutations. MLPA should thus be employed to detect CNVs of PLA2G6 in patients who show clinical features of PLAN but in whom both disease-causing mutations cannot be identified on routine sequencin

Formation of Compact Myelin Is Required for Maturation of the Axonal Cytoskeleton

Although traditional roles ascribed to myelinating glial cells are structural and supportive, the importance of compact myelin for proper functioning of the nervous system can be inferred from mutations in myelin proteins and neuropathologies associated with loss of myelin. Myelinating Schwann cells are known to affect local properties of peripheral axons (de Waegh et al., 1992), but little is known about effects of oligodendrocytes on CNS axons. The shiverer mutant mouse has a deletion in the myelin basic protein gene that eliminates compact myelin in the CNS. In shiverer mice, both local axonal features like phosphorylation of cytoskeletal proteins and neuronal perikaryon functions like cytoskeletal gene expression are altered. This leads to changes in the organization and composition of the axonal cytoskeleton in shiverer unmyelinated axons relative to age-matched wild-type myelinated fibers, although connectivity and patterns of neuronal activity are comparable. Remarkably, transgenic shiverer mice with thin myelin sheaths display an intermediate phenotype indicating that CNS neurons are sensitive to myelin sheath thickness. These results indicate that formation of a normal compact myelin sheath is required for normal maturation of the neuronal cytoskeleton in large CNS neurons