I Thought This Is What We Were Doing

My thesis is a collection of stories about men and boys who are trying to figure out what it is that they should be doing

Psychosocial predictors of health-related quality of life of South Asians with acute coronary syndrome

Introduction: South-Asians are the largest ethnic minority group in the UK. Depression and coronary heart disease (CHD) are common in this group. The importance of depression in South Asians has not attracted significant research interest, to date; yet there is evidence that it is associated with the development of CHD, and when it develops after CHD leads to poor prognosis. Objective: This study aims to investigate the effects of depression on quality of life of the South Asians under secondary care, by reviewing previous literature and performing a prospective research. The hypothesis was that, after controlling for demographic, psychological and medical variables depression would be associated with impaired HRQoL in South Asians 6 months after acute coronary syndrome (ACS). Methods: Demographic, psychological and medical data were collected. Participants completed the Hospital Anxiety and Depression Scale (HADS), Short-Form 36 (SF-36) and ENRICHD Social Support Instrument (ESSI) in the first phase. In the 2nd phase the Structured Clinical Interview for DSM-IV (SCID) was performed to validate the HADS. The PCS (SF-36) and HADS were completed at follow up. Results: Of the 250 enrolled patients 202 completed follow up. A HADS score of ≥ 17 was identified as the best cut off point. The prevalence of depression was 30%. Baseline depression, lack of education and retirement were predictors of poor QoL (p<0.05). Moreover, diabetes mellitus, respiratory and haematological disorders were associated (p< 0.05) with QoL; however after adjustment depression was the only significant predictor of poor HRQoL. Conclusions: This study suggests that depression is common in South Asians following ACS and it is associated with poor HRQoL. Further developments in the liaison psychiatry and increasing mental health knowledge of the cardiologists may help the earlier identification and subsequent treatment of depression to improve the prognosis of CHD patients.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Accessing primary health care: A meta-ethnography of the experiences of British South Asian patients with diabetes, coronary heart disease or a mental health problem

Objectives: To develop an explanatory framework of the problems accessing primary care health services experienced by British South Asian patients with a long-term condition or mental health problem. Methods: This study used meta-ethnographic methods. Published qualitative studies were identified from a structured search of six databases and themes synthesized across studies to develop a new explanatory framework. Results: Initial searches identified 951 potentially relevant records from which a total of 27 articles were identified that met inclusion and exclusion criteria. Twelve of these articles were chosen on the basis of their quality and relevance. These 12 articles described themes relating to the cultural, spatial and temporal dimensions of patient experiences of accessing and using health care. Our interpretive synthesis showed that access to primary care among British South Asians with diabetes, coronary heart disease and psychological health problems is co-constructed and negotiated over time and space along the key domains of the candidacy model of access: from help-seeking to interactions at the interface to following treatment advice. In the case of each condition, British South Asians’ claims to candidacy were constrained where their individual as well as broader social and cultural characteristics lacked fit with professionals’ ways of working and cultural typifications. Conclusion: Interventions that positively affect professionals’ capacity to support patient claims to candidacy are likely to help support British South Asians overcome a broad range of barriers to care for physical and mental health problems. </jats:p

The Presence of Charge Transfer Defect Complexes in Intermediate Band CuAl1−pFepS2

Despite chalcopyrite (CuFeS2) being one of the oldest known copper ores, it exhibits various properties that are still the subject of debate. For example, the relative concentrations of the ionic states of Fe and Cu in CuFeS2 can vary significantly between different studies. The presence of a plasmon-like resonance in the visible absorption spectrum of CuFeS2 nanocrystals has driven a renewed interest in this material over recent years. The successful synthesis of CuAl1−pFepS2 nanocrystals that exhibit a similar optical resonance has recently been demonstrated in the literature. In this study, we use density functional theory to investigate Fe substitution in CuAlS2 and find that the formation energy of neutral [FeCu]2++[CuAl]2− defect complexes is comparable to [FeAl]0 antisites when p≥0.5. Analysis of electron density and density of states reveals that charge transfer within these defect complexes leads to the formation of local Cu2+/Fe2+ ionic states that have previously been associated with the optical resonance in the visible absorption of CuFeS2. Finally, we comment on the nature of the optical resonance in CuAl1−pFepS2 in light of our results and discuss the potential for tuning the optical properties of similar systems

Opposite changes in the expression of clathrin and caveolin-1 in normal and cancerous human prostate tissue: putative clathrin-mediated recycling of EGFR

Endocytosis, an important macromolecule uptake process in cells, is known to be dysregulated in cancer. Clathrin and caveolin-1 proteins play a major role in receptor-mediated endocytosis. We have used a quantitative, unbiased and semi-automated method to measure in situ protein expression of clathrin and caveolin-1 in cancerous and paired normal (cancer adjacent, non-cancerous) human prostate tissue. There was a significant (p &lt; 0.0001) increase in the expression of clathrin in prostate cancer samples (N = 29, n = 91) compared to normal tissue (N = 29, n = 67) (N = number of patients, n = number of cores in tissue arrays). Conversely, there was a significant (p &lt; 0.0001) decrease in expression of caveolin-1 in prostate cancer tissue compared to normal prostate tissue. The opposite change in expression of the two proteins was highly correlated to increasing cancer aggressiveness. There was also a concurrent increase in the expression of epidermal growth factor receptor (EGFR), a key receptor in carcinogenesis, with clathrin in prostate cancer tissue, indicating recycling of EGFR through clathrin-mediated endocytosis (CME). These results indicate that in prostate cancer, caveolin-1-mediated endocytosis (CavME) may be acting as a brake and increase in CME may facilitate tumorigenicity and aggressiveness of prostate cancer through recycling of EGFR. Changes in the expression of these proteins can also potentially be used as a biomarker for prostate cancer to aid in diagnosis and prognosis and clinical decision-making

Comorbidity Profile and Health Care Utilization in Elderly Patients with Serious Mental Illnesses

Objectives Patients with serious mental illness are living longer. Yet there remain few studies that focus on health care utilization and its relationship to comorbidities in these elderly mentally ill patients. Design Comparative study. Information on demographics, comorbidities and health care utilization were taken from an electronic medical record system. Setting Wishard Health Services senior care and community mental health clinics. Participants Patients age 65 years and over-255 patients with serious mental illness (schizophrenia, major recurrent depression and bipolar illness) attending a mental health clinic and a representative sample of 533 non-demented patients without serious mental illness attending primary care clinics. Results Patients having serious mental illness had significantly higher rates of medical emergency room visits (p=0.0027) and significantly longer lengths of medical hospitalizations (p<0.0001) than did the primary care control group. The frequency of medical comorbidities such as diabetes, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, thyroid disease, and cancer were not significantly different between the groups. Hypertension was lower in the mentally ill group (p<0.0001). Reported falls (p<0.0001), diagnoses of substance abuse (p=0.02), and alcoholism (p=0.0016) were higher in the seriously mentally ill. The differences in health care utilization between the groups remained significant after adjusting for comorbidity levels, lifestyle factors, and attending primary care. Conclusions Our findings of higher rates of emergency care, longer hospitalizations, and increased frequency of falls, substance abuse, and alcoholism suggest the elderly seriously mentally ill remain a vulnerable population requiring an integrated model of health care

Guidelines to the agroecology-I context document

The purpose of the Context Document is threefold: first, to characterize the environmental, social and economic context of each Agroecological Living Lab (ALL); second, to understand the data and information currently available in each ALL; and third to characterize how and the extent to which agroecological principles are already being employed in each ALL. The Context Document is not meant to be a quantitative baseline or an exhaustive report, but rather a broad overview of the situation in each ALL. The data collected during the Context Document can be utilized during the visioning and assessment phases and is fundamental to describe the situation in each ALL and will inform the impact assessment. It will also be valuable to all other WPs as it will provide foundational data for their investigation