Evaluating provision of psychological assessment and support in palliative care: A national survey of hospices in England

Objective: Psychological distress is common in palliative care patients. The 2004 National Institute of Healthcare and Excellence (NICE) guidance for supportive and palliative care for adults with cancer, which remains contemporary, recognised that access to psychological support was inconsistent and often inadequate. Their 4-tier model requires multidisciplinary psychological assessment at key points. Implicit is the need for improved training and support for staff and equity in service provision. This survey was designed to determine the levels of self-reported competence amongst healthcare staff in the psychological assessment and screening of patients in adult hospices in England and their awareness of the NICE guidelines. Methods: A short anonymised online questionnaire was sent to 164 hospices to determine perceptions of healthcare professionals (HCPs) on their own competence in screening and assessment of distress, provision of therapies and levels of training and supervision. Results: Responses were received from 140 HCPs in approximately thirty-eight hospices. Key findings included self-reported needs for training and supervision. Over a quarter of nurses (28.8%) and AHPs (27.8%) had no level 2 training, and only half of nurses, AHPs and physicians were aware of the NICE guidelines. Access to level 3 specialist psychological services was lacking and some HCPs felt unable to screen and assess patients for referral to specialist services. Conclusions: Consistent, standardised training in assessment of psychological needs is required to ensuring delivery of high-quality care for psychological needs. Areas for future development identified include essential communication skills and high-quality supervision for those delivering psychotherapeutic interventions

Mutant screen reveals the Piccolo's control over depression and brain-gonad crosstalk

Successful sexual reproduction involves a highly complex, genetically encoded interplay between animal physiology and behavior. Here we developed a screen to identify genes essential for rat reproduction based on an unbiased methodology involving mutagenesis via the Sleeping Beauty transposon. As expected, our screen identified genes where reproductive failure was connected to gametogenesis (Btrc, Pan3, Spaca6, Ube2k) and embryogenesis (Alk3, Exoc6b, Slc1a3, Tmx4, Zmynd8). In addition, our screen identified Atg13 (longevity) Dlg1 and Pclo (neuronal disorders), previously not associated with reproduction. Dominant Pclo traits caused epileptiform activity and affected genes supporting GABAergic synaptic transmission (Gabra6, Gabrg3), and animals exhibited a compromised crosstalk between the brain and gonads via disturbed GnRH signaling. Recessive Pclo traits disrupted conspecific recognition required for courtship/mating and were mapped to allelic markers for major depressive disorder (Grm5, Htr2a, Sorcs3, Negr1, Drd2). Thus, Pclo-deficiency in rats link neural networks controlling sexual motivation to Pclo variants that have been associated with human neurological disorders

Kinematics of outer halo globular clusters in M31

We present the first kinematic analysis of the far outer halo globular cluster (GC) population in the Local Group galaxy M31. Our sample contains 53 objects with projected radii of ∼20-130 kpc, 44 of which have no previous spectroscopic information. GC

A-dependence of nuclear transparency in quasielastic A(e,e'p) at high Q^2

The A-dependence of the quasielastic A(e,e'p) reaction has been studied at SLAC with H-2, C, Fe, and Au nuclei at momentum transfers Q^2 = 1, 3, 5, and 6.8 (GeV/c)^2. We extract the nuclear transparency T(A,Q^2), a measure of the average probability that the struck proton escapes from the nucleus A without interaction. Several calculations predict a significant increase in T with momentum transfer, a phenomenon known as Color Transparency. No significant rise within errors is seen for any of the nuclei studied.Comment: 5 pages incl. 2 figures, Caltech preprint OAP-73

Apparatus for a Search for T-violating Muon Polarization in Stopped-Kaon Decays

The detector built at KEK to search for T-violating transverse muon polarization in K+ --> pi0 mu+ nu (Kmu3) decay of stopped kaons is described. Sensitivity to the transverse polarization component is obtained from reconstruction of the decay plane by tracking the mu+ through a toroidal spectrometer and detecting the pi0 in a segmented CsI(Tl) photon calorimeter. The muon polarization was obtained from the decay positron asymmetry of muons stopped in a polarimeter. The detector included features which minimized systematic errors while maintaining high acceptance.Comment: 56 pages, 30 figures, submitted to NI

The large-scale structure of the halo of the Andromeda galaxy. I. Global stellar density, morphology and metallicity properties

We present an analysis of the large-scale structure of the halo of the Andromeda galaxy, based on the Pan-Andromeda Archeological Survey (PAndAS), currently the most complete map of resolved stellar populations in any galactic halo. Despite the presence

The Kuiper Belt and Other Debris Disks

We discuss the current knowledge of the Solar system, focusing on bodies in the outer regions, on the information they provide concerning Solar system formation, and on the possible relationships that may exist between our system and the debris disks of other stars. Beyond the domains of the Terrestrial and giant planets, the comets in the Kuiper belt and the Oort cloud preserve some of our most pristine materials. The Kuiper belt, in particular, is a collisional dust source and a scientific bridge to the dusty "debris disks" observed around many nearby main-sequence stars. Study of the Solar system provides a level of detail that we cannot discern in the distant disks while observations of the disks may help to set the Solar system in proper context.Comment: 50 pages, 25 Figures. To appear in conference proceedings book "Astrophysics in the Next Decade

The CHEK2 1100delC mutation identifies families with a hereditary breast and colorectal cancer phenotype

Because of genetic heterogeneity, the identification of breast cancer-susceptibility genes has proven to be exceedingly difficult. Here, we define a new subset of families with breast cancer characterized by the presence of colorectal cancer cases. The 1100delC variant of the cell cycle checkpoint kinase CHEK2 gene was present in 18% of 55 families with hereditary breast and colorectal cancer (HBCC) as compared with 4% of 380 families with non-HBCC (P<.001), thus providing genetic evidence for the HBCC phenotype. The CHEK2 1100delC mutation was, however, not the major predisposing factor for the HBCC phenotype but appeared to act in synergy with another, as-yet-unknown susceptibility gene(s). The unequivocal definition of the HBCC phenotype opens new avenues to search for thi

Using induced pluripotent stem cells to investigate human neuronal phenotypes in 1q21.1 deletion and duplication syndrome

Copy Number Variation (CNV) at the 1q21.1 locus is associated with a range of neurodevelopmental and psychiatric disorders in humans, including abnormalities in head size and motor deficits. Yet, the functional consequences of these CNVs (both deletion and duplication) on neuronal development remain unknown. To determine the impact of CNV at the 1q21.1 locus on neuronal development, we generated induced pluripotent stem cells from individuals harbouring 1q21.1 deletion or duplication and differentiated them into functional cortical neurons. We show that neurons with 1q21.1 deletion or duplication display reciprocal phenotype with respect to proliferation, differentiation potential, neuronal maturation, synaptic density and functional activity. Deletion of the 1q21.1 locus was also associated with an increased expression of lower cortical layer markers. This difference was conserved in the mouse model of 1q21.1 deletion, which displayed altered corticogenesis. Importantly, we show that neurons with 1q21.1 deletion and duplication are associated with differential expression of calcium channels and demonstrate that physiological deficits in neurons with 1q21.1 deletion or duplication can be pharmacologically modulated by targeting Ca2+ channel activity. These findings provide biological insight into the neuropathological mechanism underlying 1q21.1 associated brain disorder and indicate a potential target for therapeutic interventions

Momentum transfer dependence of nuclear transparency from the quasielastic 12C(e,e’p) reaction

The cross section for quasielastic 12C(e,e’p) scattering has been measured at momentum transfer Q2=1, 3, 5, and 6.8 (GeV/c)2. The results are consistent with scattering from a single nucleon as the dominant process. The nuclear transparency is obtained and compared with theoretical calculations that incorporate color transparency effects. No significant rise of the transparency with Q2 is observed