The SF36 as an outcome measure of services for end stage renal failure

OBJECTIVE: —To evaluate the use of the short form 36 (SF36) as a measure of health related quality of life of patients with end stage renal failure, document the results, and investigate factors, including mode of treatment, which may influence it. DESIGN: Cross sectional survey of patients with end stage renal failure, with the standard United Kingdom version of the SF36 supplemented by specific questions for end stage renal failure. SETTING: A teaching hospital renal unit. Subjects and methods—660 patients treated at the Sheffield Kidney Institute by haemodialysis, peritoneal dialysis, and transplantation. Internal consistency, percentage of maximal or minimal responses, SF36 scores, effect sizes, correlations between independent predictor variables and individual dimension scores of the SF36. Multiple regression analysis of the SF36 scores for the physical functioning, vitality, and mental health dimensions against treatment, age, risk (comorbidity) score, and other independent variables. RESULTS: A high response rate was achieved. Internal consistency was good. There were no floor or ceiling effects other than for the two “role” dimensions. Overall health related quality of life was poor compared with the general population. Having a functioning transplant was a significant predictor of higher score in the three dimensions (physical functioning, vitality, and mental health) for which multiple regression models were constructed. Age, sex, comorbidity, duration of treatment, level of social and emotional support, household numbers, and hospital dialysis were also (variably) significant predictors. CONCLUSIONS: The SF36 is a practical and consistent questionnaire in this context, and there is evidence to support its construct validity. Overall the health related quality of life of these patients is poor, although transplantation is associated with higher scores independently of the effect of age and comorbidity. Age, comorbidity, and sex are also predictive of the scores attained in the three dimensions studied. Further studies are required to ascertain whether altering those predictor variables which are under the influence of professional carers is associated with changes in health related quality of life, and thus confirm the value of this outcome as a measure of quality of care

A comparison of faecal analysis with backtracking to determine the diet composition and species preference of the black rhinoceros (Diceros bicornis minor)

The diet of black rhinoceros (Diceros bicornis minor) was studied using backtracking and faecal analysis in South Africa. Both methods yielded different results, with a large bias for dominant species. Results of backtracking showed that the rhinos browsed on 80 plant species. Grasses comprised 4.5% of the diet in the faecal analysis, but were not recorded during the backtracking. The backtracking method, along with a measure of forage availability, was used to identify two groups of plant species, those species taken in a higher proportion than available in the field and those taken in a lower proportion. Chemical analyses showed that these two species groups were similar in in vitro digestibility, macro-elements and fibre constituents. Mean bite size and species contribution to the diet were not correlated with any of the forage quality parameters, indicating that rhinos were not maximising nutrient intake or minimising fibre intake of these consumed plant species

Framing a Consent Form to Improve Consent Understanding and Determine How This Affects Willingness to Participate in HIV Cure Research: An Experimental Survey Study

HIV cure research carries serious risks and negligible benefits. We investigated how participants understand these risks and what influences their willingness to participate. Through internet-based and in-person convenience sampling, 86 HIV+ participants completed an experimental survey. Participants were randomized to read a standard consent form describing a hypothetical HIV cure study or one adapted using Fuzzy Trace Theory—a decision-making model to facilitate complex information processing. We measured consent understanding and cognitive (e.g., safe/harmful) and affective (e.g., concerning, satisfying) evaluations of HIV cure research. Participants who read the adapted consent form had improved consent understanding, but only positive affective evaluations were associated with a willingness to participate. Consent processes can use decision-making theories to facilitate comprehension of study information

Detection of aggrecanase- and MMP-generated catabolic neoepitopes in the rat iodoacetate model of cartilage degeneration

AbstractObjectiveTo characterize the time course of aggrecan and type II collagen degradation in the rat iodoacetate model of cartilage degeneration in relationship to the temporal sequence that has been described in human osteoarthritis (OA).DesignRats were injected intra-articularly in one knee joint with iodoacetate and damage to the tibial plateau was assessed from digitized images captured using an image analyzer. The articular cartilage from the tibial plateau was harvested, extracted and glycosaminoglycan (GAG) content was measured using the dimethylmethylene blue (DMMB) assay. Cartilage aggrecan neoepitopes were detected in cartilage extracts by Western blotting using antibodies recognizing the aggrecanase-generated C-terminal neoepitope NITEGE (BC-13) and the MMP-generated C-terminal neoepitope DIPEN (BC-4). A type II collagen collagenase-generated neoepitope was detected in cartilage extracts by ELISA using the Col2-3/4Cshort antibody; denatured collagen was detected using the Col2-3/4m antibody.ResultsDegenerative joint changes and proteoglycan (GAG) loss progressed with time after iodoacetate injection. Western blotting of cartilage extracts of iodoacetate treated rats demonstrated an increase in both aggrecanase- and MMP-generated epitopes with the NITEGE aggrecanase neoepitope being significantly elevated on days 7, 14 and 21 while DIPEN the MMP neoepitope was significantly elevated on days 7 and 14. The type II collagen neoepitope recognized by Col2-3/4Cshort was significantly increased in cartilage extracts of rats at days 14 and 21 after iodoacetate injection.ConclusionThe proteoglycan fragments extracted from the knee cartilage of rats after the intra-articular injection of iodoacetate appeared to result from cleavage at both aggrecanase and MMP sites. Cleavage of type II collagen by collagenase was also detected after iodoacetate injection and occurred subsequent to the initiation of aggrecan loss. These observations serve to demonstrate similarities in the mechanisms of cartilage degeneration induced by iodoacetate to those seen in articular cartilage in OA

Stresses in a half space due to Newtonian gravitation

An efficient general solution is obtained for the problem of the elastic half space z > 0 with a traction-free surface experiencing gravitational attraction to an arbitrarily shaped body located in z < 0. Many components of the stress field can be written down immediately if the potential of the attracting body is known. Results are given for the case of attraction to a uniform sphere.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42687/1/10659_2005_Article_4105.pd

Effect of the momentum dependence of nuclear symmetry potential on the transverse and elliptic flows

In the framework of the isospin-dependent Boltzmann-Uehling-Uhlenbeck transport model, effect of the momentum dependence of nuclear symmetry potential on nuclear transverse and elliptic flows in the neutron-rich reaction $^{132}$Sn+$^{124}$Sn at a beam energy of 400 MeV/nucleon is studied. We find that the momentum dependence of nuclear symmetry potential affects the rapidity distribution of the free neutron to proton ratio, the neutron and the proton transverse flows as a function of rapidity. The momentum dependence of nuclear symmetry potential affects the neutron-proton differential transverse flow more evidently than the difference of neutron and proton transverse flows as well as the difference of proton and neutron elliptic flows. It is thus better to probe the symmetry energy by using the difference of neutron and proton flows since the momentum dependence of nuclear symmetry potential is still an open question. And it is better to probe the momentum dependence of nuclear symmetry potential by using the neutron-proton differential transverse flow and the rapidity distribution of the free neutron to proton ratio.Comment: 6 pages, 6 figures, to be published by EPJ

Negative Kaons in Dense Baryonic Matter

Kaon polarization operator in dense baryonic matter of arbitrary isotopic composition is calculated including s- and p-wave kaon-baryon interactions. The regular part of the polarization operator is extracted from the realistic kaon-nucleon interaction based on the chiral and 1/N_c expansion. Contributions of the Lambda(1116), Sigma(1195), Sigma*(1385) resonances are taken explicitly into account in the pole and regular terms with inclusion of mean-field potentials. The baryon-baryon correlations are incorporated and fluctuation contributions are estimated. Results are applied for K- in neutron star matter. Within our model a second-order phase transition to the s-wave K- condensate state occurs at rho_c \gsim 4 \rho_0 once the baryon-baryon correlations are included. We show that the second-order phase transition to the p-wave $K^-$ condensate state may occur at densities $\rho_c \sim 3\div 5 \rho_0$ in dependence on the parameter choice. We demonstrate that a first-order phase transition to a proton-enriched (approximately isospin-symmetric) nucleon matter with a p-wave K- condensate can occur at smaller densities, \rho\lsim 2 \rho_0. The transition is accompanied by the suppression of hyperon concentrations.Comment: 41 pages, 24 figures, revtex4 styl