Evolution and change in palliative care around the world

Palliative care developed in the later part of the 20th century as a social movement and medical speciality. Central to its modern development were the ideas of Dr Cicely Saunders, whose vision for improving the care of the dying encompassed the physical, psychological, social and spiritual domains while emphasizing the importance of rigorous clinical practice, training and research. St Christopher’s Hospice, which she founded, inspired generations of practitioners and influenced the expansion of hospices nationally and internationally. Terminal care evolved into the discipline of palliative care, which applied holistic principles to the care of those earlier in their disease trajectory and in different settings, such as hospitals and the community. Some countries now have national strategies for palliative care that are supported by government. Palliative care attracts increasing attention as an aspect of the public health system and there are calls for access to it to be recognized as a human right. Yet around the world, palliative care is not uniformly developed and it needs to press hard to secure full integration with prevailing health policies. Palliative care still reaches only a tiny proportion of those who could benefit from it, especially those with diseases other than cancer. The global challenge for palliative care in the 21st century is to develop models and coverage appropriate to those in need, whatever their diagnosis, income or setti

Analysis of two genomes from the mitochondrion-like organelle of the intestinal parasite Blastocystis: complete sequences, gene content, and genome organization.

Acquisition of mitochondria by the ancestor of all living eukaryotes represented a crucial milestone in the evolution of the eukaryotic cell. Nevertheless, a number of anaerobic unicellular eukaryotes have secondarily discarded certain mitochondrial features, leading to modified organelles such as hydrogenosomes and mitosomes via degenerative evolution. These mitochondrion-derived organelles have lost many of the typical characteristics of aerobic mitochondria, including certain metabolic pathways, morphological traits, and, in most cases, the organellar genome. So far, the evolutionary pathway leading from aerobic mitochondria to anaerobic degenerate organelles has remained unclear due to the lack of examples representing intermediate stages. The human parasitic stramenopile Blastocystis is a rare example of an anaerobic eukaryote with organelles that have retained some mitochondrial characteristics, including a genome, whereas they lack others, such as cytochromes. Here we report the sequence and comparative analysis of the organellar genome from two different Blastocystis isolates as well as a comparison to other genomes from stramenopile mitochondria. Analysis of the characteristics displayed by the unique Blastocystis organelle genome gives us an insight into the initial evolutionary steps that may have led from mitochondria to hydrogenosomes and mitosomes

Pacific Confrontations: Historical Lessons for the Sino-American Strategic Relationship

Senior Project submitted to The Division of Social Studies of Bard Colleg

X-ray and neutron topography observations of domains aim dislocations

A brief introduction to the theory of magnetism and magnetic domains is given which is followed by a review of X-ray topography techniques and an outline of the theory and contrast mechanisms necessary for the interpretation of the topographs. Results are presented on the perfection of flux grown rare-earth germanate crystals which clearly indicate the usefulness, to the crystal grower, of synchrotron X-ray topography for rapid routine assessment of a large number of crystals. The techniques of neutron topography are described and some of the more important results obtained are reviewed. Results obtained with neutron topography on the possible correlation between surface vicinal features and dislocations in holmium galium garnet are presented. These results, although not conclusive, provide further evidence of a probable correlation. Previous work reported on the antiferromagnetic KCoF(_3) is described with particular reference to the limited number of domain observations. Previous work on the motion of antiferromagnetic domain walls under an applied magnetic field has been extended by considering the case of the motion of these walls under an applied stress using both synchrotron X-ray topography and rocking curve measurements. The critical stress achieved was in reasonable agreement with that predicted from the magnetic field data. These results also confirm that data obtained in torque magnetometry and linear dichroism experiments may be explained by the motion of antiferromagnetic domain walls under stress. Work on the magnetic properties of terbium is reviewed, particularly work relating to measurements of magnetostriction. An X-ray technique for measuring the magnetostriction of high magnetostriction materials without resorting to absolute lattice parameters is described and the results obtained on using this technique to measure the magnetostriction of terbium are presented. These results are fitted to a two-ion interaction model. Work on the highly magnetostrictive Tb(_.27)Dy(_.73)FE(2) is described and results are presented on the observation of magnetic domains in this material in an applied magnetic field. Calculations of the domain wall energies and widths are presented which enabled the domain structure to be interpreted

Statistical efficiency in distance sampling

Distance sampling is a technique for estimating the abundance of animals or other objects in a region, allowing for imperfect detection. This paper evaluates the statistical efficiency of the method when its assumptions are met, both theoretically and by simulation. The theoretical component of the paper is a derivation of the asymptotic variance penalty for the distance sampling estimator arising from uncertainty about the unknown detection parameters. This asymptotic penalty factor is tabulated for several detection functions. It is typically at least 2 but can be much higher, particularly for steeply declining detection rates. The asymptotic result relies on a model which makes the strong assumption that objects are uniformly distributed across the region. The simulation study relaxes this assumption by incorporating over-dispersion when generating object locations. Distance sampling and strip transect estimators are calculated for simulated data, for a variety of overdispersion factors, detection functions, sample sizes and strip widths. The simulation results confirm the theoretical asymptotic penalty in the non-overdispersed case. For a more realistic overdispersion factor of 2, distance sampling estimation outperforms strip transect estimation when a half-normal distance function is correctly assumed, confirming previous literature. When the hazard rate model is correctly assumed, strip transect estimators have lower mean squared error than the usual distance sampling estimator when the strip width is close enough to its optimal value (± 75% when there are 100 detections; ± 50% when there are 200 detections). Whether the ecologist can set the strip width sufficiently accurately will depend on the circumstances of each particular study

Development and piloting of a food-based intervention to increase vitamin E intake in pregnant women in a randomised controlled trial

Acknowledgement This study was funded by the University of Aberdeen and an unrestricted grant from Baxters Food Group Ltd. LC acknowledges funding from the RESAS programme of the Scottish Government.Peer reviewedPublisher PD

An intelligent modelling interface for process simulators in process industries

Over the past three decades, modelling packages for chemical processes have become more advanced and widely used. For example, equation-oriented dynamic simulators, such as gPROMS are useful for simulating plantwide processes as well as unit operations, and are widely used by process engineers. Whereas, other types of simulator (e.g. Simulink) are often used by control engineers to solve complex control problems. However, both these types of simulator rely on the user being proficient in modelling and familiar with their syntax beforehand. A useful development would be the integration of some knowledge into the formation of the process models and automatic syntax code generation. This would lead to the design engineers having a library of knowledge to check on first, much as an expert engineer uses their past experiences to help guide them through a design. If this could be incorporated into a modelling interface this would greatly help the design engineer, especially when tackling problems in areas that they have little, or no experience. The thesis addresses this problem and describes the design of an intelligent modelling interface that incorporates a knowledge base using some form of a priori case library and recall facility. The interface also incorporates an automatic input file generation stage. At present, the user can: specify a single unit operation problem to search for, retrieve similar cases from the database, specify their solution in the database based on past cases and experience, and then automatically generate an input file for either gPROMS or Simulink. These features are demonstrated through four case studies

Reflections on SoTL in a Graduate Health Professions Course Sequence

Facilitating learning in graduate programs that prepare students to enter a health profession presents unique challenges since students in these programs have completed undergraduate degrees, but are entering graduate studies in a new field. This paper describes the SoTL process used by two faculty members to facilitate independent learning and critical thinking in a course sequence in a graduate physical therapy program. Design, implementation, and outcomes of modifications to the course sequence are described. The paper includes our reflections on the SoTL process and lessons learned about strategies for facilitating learning in this student population

Likelihood of death within one year among a national cohort of hospital inpatients in Scotland

No abstract available

Estimating local car ownership models

Many studies in the transport demand literature have shown that income is an important factor in determining how many cars a household owns. When the models used to measure the strength of this relationship are estimated on cross-sectional data, they typically yield one overall value as the estimate. Local circumstances will, however, vary. This paper illustrates the use of the Geographically Weighted Regression technique to estimate the individual strength of this relationship for each of the United Kingdom electoral wards. Use of this type of model enables a wards’ income elasticity to be based on both the local estimate of the strength of this relationship and the current local level of car ownership. How the use of this local elasticity changes future forecasts of the size of the vehicle fleet is illustrated